Registration

MSA Juniors Division

Players Registration

Player Information

Name: Sex: Date of Birth:

Player's Age on 5/1/2012:

Please Remember Shirts Do Run Small So Order Appropriately, No Changes After Order Is Placed!!

Shirt Size: If you played last year, which team were you on:

Please list any physical conditions the Coach should be aware of, enter NONE if appropriate:

Parent / Guardian Address & Contact Information

Parent or Guardian Name:

Address: City: State: Zip:

Phone Number: Emergency Phone:

E-Mail Address:

Support Your Team & MSA

MSA is a non-profit organization and is made possible by volunteers. Please let us know if you'd like to volunteer for any of the following positions: (Please check one or more)

Commissioner Head Coach Base Coach Team Parent Scorekeeper Concessions Fields Help Yearbook Other

Please list any suggestions or special requests you might have for MSA:

By submitting this registration you agree as the Parent, Guardian or Participant 18 years or older, herby assume any and all liability and responsibility for injury to your child/self in any MSA related activity. I hereby release MSA from any such liability and assume all risk related to softball.

Madison Weather Forecast, OH