REGISTRATION FORM 2011
print and mail with your fee

PLAYER’S NAME:____________________________________________                          AGE:______________

(PLEASE PRINT)                                                                                                                                                                                                  (AS OF JAN 1, 2011)

ADDRESS:___________________________________________________

CITY:________________________________________________________POSTAL CODE:_________________

PHONE NUMBER:_________________________  E-MAIL:__________________________________________

BIRTHDATE:   Day:__________   Month:_____________  Year:_______________

PREVIOUS DIVISION:   _________________________     PREVIOUS TEAM:___________________________

SPECIAL REQUESTS:________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

Is this Player a Pitcher:   Yes_______     No_____                   Is this Player a Catcher:  Yes________     No_____

                We are committed to protecting the privacy of your personal information.  We maintain a record of our interaction.  Occasionally, we may contact you with softball related communications.  If you have any questions or concerns regarding the privacy of your personal information, please contact the  S.C.L.S.L Secretary.

CONSENT: 1.         I agree that the ST. CATHARINES LADIES SOFTBALL LEAGUE EXECUTIVE and COACHES shall not be liable in case of accident or injury however caused.

      2.        I agree that all equipment and uniforms are property of the League

      3.        I consent to the use of the above personal information for the purposes of communicating the ST. CATHARINES LADIES SOFTBALL League's programs, events, and           activities.

Signature:___________________________________________________    Date:__________________________

Please print form, fill out, sign and send with payment to:

Pam Deichert (Registrar)

46 Andrea Drive

ST. CATHARINES, ON   L2S 3N8                                            Payment Received:_________________________