UNION COUNTY SENIOR SOFTBALL LEAGUE

 

2010 REGISTRATION FORM

 

“Lets Play Ball and Have Some Fun”

 

 

 

PLEASE PRINT CLEARLY:

 

 

 

Last Name: ____________________________          First Name: _______________________

 

 

 

Street Address: ______________________________________________________________

 

 

 

City or Town: ____________________________            Zip Code: ___________

 

 

 

Home Phone: _____________________________            Uniform shirt size: ________

 

 

 

Email address: __________________________________________________________

 

 

 

Did you receive league communications at this email address in 2009?    YES           NO       (Circle One)

 

 

 

Date of Birth: _____________________                      Age on Dec. 31, 2010: _______

 

 

 

 

 

1.             Have you participated in the UCSSL previously?             YES           NO       (Circle One)

 

 

 

2.             If you answered YES above, what team(s) did you play on?

 

 

 

                (50’s) ________________________________ (60’s) _________________________________

 

 

 

3.             Are you currently assigned to a team(s)?

 

               

 

(50’s) ________________________________ (60’s) _________________________________

 

 

 

** NOTE:   all NEW  players must submit a photocopy of both sides of their driver’s license  **

 

 

 

Cost for membership in the UCSSL …….…………………………………………   $65.00

 

Total cost to play in both the 50’s and 60’s …………………………………….…  $115.00

 

 

 

All players: Please read the following, and sign where indicated.

 

The Union County Senior Softball League will not accept registration forms not signed!

 

 

 

STATEMENT OF DISCHARGE OF LIABILITY

 

 

 

I sign this form as my Voluntary Act and by this act I agree to exclude the Union County Senior Softball League and all of its officers

 

and League officials from any claims, suits or other actions arising from, caused by, or which are the alleged result of any Act or

 

omission by the League.  I agree to participate in League play in the Union County Senior Softball League at my own risk  and any

 

injuries which I may incur  will be paid for through my own personal medical plan or from my own personal funds.  This statement

 

remains in effect as long as I participate in the Union County Senior Softball League or until I submit a written request to void this

 

Statement of Discharge of Liability.  I hereby certify that the above information is correct, and I realize that I am liable to be banned

 

from UCSSL for life if the information is found to be false.

 

 

 

LEGAL SIGNATURE:   ____________________________________    DATE:__________________

 

 

 

Return completed form, with payment (and copies of license if you are new to the league),

 

to team manager, or mail to:     UCSSL   938 Summit Ave.   Westfield, NJ  07090