U12 Registration Ages 11-12 Player Name Gender —Please choose an option—MaleFemale Birthdate Home Phone Email Mailing Address Parent/Guardian Name Parent/Guardian Phone Number Player Medical Information MSP Care Card Number Doctor Name Doctor Phone Dentist Name Dentist Phone Medical Concerns and Allergies ACCIDENT WAIVER: By clicking this box, I agrees that Sechelt Minor Softball, executive, coaches, and assistants will not be held responsible for any accidents, injury, or loss, however caused, and agrees to release those named above from any or all claims or damages which may arise as a result of, or reason of, such accident, injury, or loss. A limited accident insurance policy is held through a private insurance company. SECHELT MINOR SOFTBALL MEMBERSHIP: I am the parent/guardian of player on this form, who is a registered player of the Sechelt Minor Softball Association (SMSA). In accordance with the requirement that a parent or guardian of each player be a member of the SMSA, I hereby apply for membership in the Association for the 2020 season. A fee in the amount of $1.00 has been paid for membership to June 30, 2020. League Participation Board MemberCoach/AssistantTeam ManagerTournament VolunteerUmpire IMPORTANT: After pressing “Send”, you will be asked for payment through a secure credit card processor. Wait for the confirmation page for your receipt and confirmation code to ensure your registration has come through.