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 02 Registration Form |
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Sunday, January 6
2002 Registration Jan 28 @ DCHS
Click here to download and print the 2002 registration form Adobe Acrobat required to view
DCBA Registration form
Parent information
Name: _________________________________________________Phone: _________________
Address: _______________________________________________MN Zip ________________
Email: ____________________________________ Cell Phone __________________________
I would like to be a coach - Yes/No --- volunteer umpire – Yes / No
The DCBA is looking for volunteers to help with different events, can we call you – Yes / No
Player information
Name ___________________________________________________ DOB _____/ _____/ ____
Grade level ____________________.
Emergency Information:
Contact other then parents: ___________________________________Phone________________
Contact other then parents: ___________________________________Phone________________
DR: _____________________________ Clinic ________________________________________
Health Concerns:
______________________________________________________________________________
I _____________________________________ hereby by consent & authorize my son to participate in summer baseball sponsored by the DCBA. With this consent I hereby release the DCBA, the cities of Dassel & Cokato, Meeker County and the D-C School Dist. from any and all liability if my son is injured well participating. The DCBA and their coaches have my permission to act for me in accordance to their best judgment in any emergency involving my son.
Parent or Guardian Signature: ________________________________________Date _________
DCBA ONLY
Team assignment: _______________________, Coach: ________________________________
Uniform Number: ______________________________________________________________
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