2016 SYSA Baseball Registration

First

Middle

Last

Date of Birth

Date

Age:

Cell Phone:

Address:

City/State/Zip

Apt/Suite/Bldg.

Jersey Size

Pants Size

Father's Name

Work Phone:

Work Email:

Mother"s Name

Work Phone:

Work Email:

In Case of an Emergency Contact:

Phone #:

School:

Grade Level:

Teacher/Homeroom Teacher:

Principal:

Who does the child live with?

MotherFatherBothOther: (Please explain in comments section)

Did your child play last year?

If so, where?

Does the child have any disabilities, handicaps, present injuries or limitations, allergies, hemophelia, heart, condition, history of respiratory illness or other significant medical condition?

If yes, please state condition:

If you wish to have your doctor contacted in case of emergency: Doctor"s Name/Hospital/Phone

EMERGENCY AUTHORIZATION (from Above) I, the parent or guardians of the participant, a minor, hereby authorize the coaches, staff, or volunteers of SYSA, as my Agents, to consent to medical examination of my child. In case of emergency, I hereby authorize treatment, and/or care at any hospital. If there is an emergency and I cannot be reached, please contact the above emergency contact.

By checking the “I Accept the Terms and Conditions” box and clicking the "Submit" button onthis page, you acknowledge you have read and agree to the above.

WAIVER OF LIABILITY, DISCLAIMER, AND PERMISSION I, the parent or guardian of the above named individual, acknowledge that participation in athletic events necessarily involves the risk of physical injury. I further acknowledge that the programs of SYSA are primarily administered by a small staff, and unpaid volunteers. In consideration for accepting the registration of the named individual and permitting the voluntary participation of said individual in its programs, I (for myself as well as my child, his/her heirs and assigns) hereby release, discharge, and hold harmless the SYSA, its employees, volunteers and other representatives or affiliates from and against any claims arising out of or relating to illness, physical injury, death, or other damages while participating with the SYSA organization. I give my permission for free use of my child’s name and picture in broadcasts, telecasts or written accounts of any game, practice or participation in any SYSA sponsored event. I also understand that it is my responsibility to provide Medical and Injury insurance for my child.

By checking the “I Accept the Terms and Conditions” box and clicking the "Submit" button onthis page, you acknowledge you have read and agree to the above.

SYSA is a 100% volunteer-run operation. It takes a team effort on the part of both players and families alike to create a season full of fun and life-long memories.

Board Members, League Officers, Managers, and Coaches volunteer countless hours before, during, and after the season to ensure that the league runs successfully.

We can't do it alone, however. It takes the effort of our entire adult membership to provide our children with the type of Little League experience they deserve!

Each parent or guardian is required to work one concession stand shift during the regular season.

We do offer a buy-out option for those that do not wish to volunteer their time and enthusiasm. The buy-out amount $60 will suffice for parents to opt-out of volunteer service. Please note that a manager still might require assistance from parents during the season regardless of any buy-out.

By checking the “I Accept the Terms and Conditions” box and clicking the "Submit" button onthis page, you acknowledge you have read and agree to the above.

Choose which volunteer position fits you!

REQUIRED

Original Birth CertificateRegistration Fee $65.00 NON-REFUNDABLE

Additional Comments:

Pay Online

Choose Payment Type:

Baseball Registration $50 ($52 w/ service fee)

USDBaseball Registration

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Participant Name

Uniform Size Information

Parent/Guardian Information

Volunteer Options