Summer Pick Up Game Registration

Participant's First Name

Participant's Last Name

Association

Participant's Age Level

Rising 12U

Played 10U this spring but will move up next spring

12U

Played 12U this spring

14U

Played 14U this spring

Parent/Guardian 1 Name

Parent/Guardian 1 Email Address

Parent/Guardian 1 Best Phone Number for Texts

Parent/Guardian 2 Name

Parent/Guardian 2 Email Address

Parent/Guardian 2 Best Phone Number for Texts

Health Issues - See Below

Please tell us of any health issues (or any issues) that we, as coaches, would need to know about. Example - asthma, arthritis, allergies, anxiety, etc. If there are none, please type "none".

Waiver - See Below

I Agree

I/We hereby give my/our permission for my/our daughter to participate in events hosted by Swatara Paxtang Softball Association. I/We know that participation in softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify and agree to hold harmless, Swatara Paxtang Softball Association, any/all board members, coaches, and program/activity organizers from any claim arising out of any injury to my/our child whether the result of negligence or any other cause.

Photo Waiver - See Below

I Agree

I/We hereby give my/our permission for Swatara Paxtang Softball Association, any/all board members, coaches, and program/activity organizers to take photographs/video of my/our child and use them on social media to showcase this clinic and the Swatara Paxtang Softball Association.