SOUTH AUGUSTA BASEBALL LEAGUE

REGISTRATION FORM & TREATMENT CONSENT

LAST

FIRST MAILING ADDRESS MI PHYSICAL ADDRESS

MOTHERS NAME FATHERS NAME DATE OF BIRTH Home Phone Other Phone HIGH SCHOOL YOUR CHILD WILL ATTEND WILL HE/SHE BEING PLAYING ON ANY OTHER ORGANIZED BASEBALL TEAMS _____YES _____NO FAMILY PHYSICIAN ARE THERE ANY REQUIRED MEDICATIONS? (please include any medication) PHONE Mother's Cell Father's Cell Relationship AGE AS OF 4/30

SHOULD WE BE AWARE OF ANY SPECIAL NEEDS OF YOUR CHILD? MEDICAL CARE OR TREATMENT RESULTING IN HIS/HER INVOLVEMENT IN LEAGUE ACTIVITIES?

YES

NO

PLEASE EXPLAIN

IN CASE OF AN ACCIDENT OR ILLNESS, I HEREBY AUTHORIZE A REPRESENTATIVE OF SOUTH AUGUSTA BASEBALL LEAGUE TO USE HIS/HER JUDGEMENT IN OBTAINING IMMEDIATE MEDICAL CARE. DATE Desired Jersey # 1st 2nd CIRCLE ONE: This year's level Last year's team PARENT/GUARDIAN SIGNATURE ****Parent Shirt $15, Hats $20**** Name Number Uniform Info. Pant Size Shirt Size

T-Ball (6u)

Rookie (8U)

Minor (10U)

Major (12U)

If you have not played for SABL, Where did you last play?

Yes or No

This year SABL is offering an exemption to any parent not wishing to work the concessions. The $30.00 fee covers the cost of paying FCCLA to staff the window . This year SABL is offering an exemption to any parent not wishing to participate in the fundraiser. The $100.00 fee covers the minimum amount per player.

Yes or No

Notes

If you would NOT like your child's picture to be appear in any SABL media please check this box

I have read and agree to follow the parent pledge.

DATE

PARENT/GUARDIAN SIGNATURE

Player's Name SPRING Registration first player Registration second player Registration third player Registration T-Ball Registration T-Ball second Sub-total Registration Total Exemption from concession Exemption from fundraising Parent Shirt Exemption Total Gun Raffle Ticket Numbers Box of Beef Sticks Sub-total Initials Grand Total $50.00 $30.00 $100.00 $15.00 $60.00 $50.00 $50.00 $50.00 $45.00

Parent Name SUMMER $45.00 $40.00 $35.00 FALL $50.00 $45.00 $40.00

Contact #

Check#

Cash