2015 REGISTRATION
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: ______ number:
______
Email
address: ______________________________________________________________
Would you like to receive
league communications at this email address in 2015? YES NO (Circle
One)
Date of Birth: ______________________________ Age on
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?
(50s)
________________________________ (60s) _________________________________
3. Are you currently assigned to a
team(s)?
(50s) ________________________________ (60s)
_________________________________
** NOTE: all NEW players must submit a photocopy of both
sides of their drivers license **
Cost for membership in the UCSSL
.
$75.00
Total cost to play in both the
50s and 60s
$135.00
All players: Please read the following, and sign where indicated.
The
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
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 (preferred), or
mail to: UCSSL