UCSSL 2021 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 2021? 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, for how
many consecutive years? ___________
3. Are you currently assigned to a
team(s)? If so, what team?
(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
(per team) ……………………....……............. $ 80.00
Reduced (one year only) cost for
players who paid the full 2020 UCSSL fee ……
$ 55.00
All players: Please carefully
read the following, and sign where indicated.
The
STATEMENT OF DISCHARGE OF LIABILITY
I am fully aware of the inherent risks and hazards
in connection with my participation in any UCSSL games, including illness,
disability and deaths. I understand that
this risk includes the exposure to or contraction of communicable diseases
including COVID-19. I acknowledge that I
am increasing my risk of exposure to COVID by participating in UCSSL games,
practices and meetings. I voluntarily
assume the risk of any injury or illness, regardless of the severity including
death that I may incur as a result of my participation. I understand that the assumption of risk
includes, without limitation, risks associated with maintenance of fields,
accessories and equipment. I recognize
that I am solely responsible for my decision to participate in UCSSL
games. If I choose not to have a vaccine
before the season or at any time after it becomes available, I do so with the
understanding that I assume all risks involved with that decision.
I agree to abide by all rules and regulations set
forth by the Center for Disease Control (CDC), State of New Jersey Department
of Health and UCSSL related to coronavirus and other communicable diseases.
I understand that if I travel outside the State of
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 to
UCSSL (and copies of license if you are new to the league),