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Sunday, February 5 2012 PLAYER REGISTRATION 2/5/2012 Missed Walk-In registration Please mail your completed form to: MAA Baseball 4015 Bittersweet Circle Collegeville, PA 19426-4008 2012 METHACTON ATHLETIC ASSOCIATION BASEBALL REGISTRATION Baseball Ages 13 to 15. We play at MHS JV Field (Mill Road) & Heebner Park, Worcester Player’s Name (First, Middle, Last) Birth Date Age* ___/___/___ ___/___/___ Registration Fee: $150 per player * Born on or between the dates of May 1, 1998 and April 30,1999, is League age 13 * Born on or between the dates of May 1, 1997 and April 30,1998, is League age 14 * Born on or between the dates of May 1, 1996 and April 30,1997, is League age 15 Mail-In registration cutoff is January 14, 2012 To register by mail, send 1) a completed registration form, and 2) a check payable to MAA or Methacton Athletic Association for the correct amount to the following address: Chuck Eppolito 3226 Fisher Road Lansdale, PA 19446-5808 NOTE: Mail-In registration closes on January 14, 2012 Lower Providence Fire House Walk in Date 1/28/2012 9-Noon Walk in Date 2/04/2012 9-Noon Parental Volunteers The league can only run with the help of volunteers. We really need help with Coaches and Umpires. ( ) Coach: ______________________ ( ) Umpire ________________________ ( ) Assistant Coach: ______________________ ( ) Ground Crew – Game day ________________________ ( ) In lieu of Volunteering I make a contribution of $________ (please add this amount to your registration fee) HOLD HARMLESS AGREEMENT The hazards associated with playing baseball include, but are not limited to being injured when hit by the ball or bat, by falling or sliding, or sustaining injury relating to weather or Act of God. WHEREAS, Methacton Athletic Association, Norristown, PA has offered to organize a community athletic program within which the Player wishes to participate, and the Player, the undersigned parents or guardians, or their respective heirs, executors, administrators or assignees hereby agree to hold harmless and indemnify Methacton Athletic Association, its coaches, parent participants and agents, against all claims and losses arising due to any injuries or deaths which might be sustained by Player while he is engaged in, and agree to waive all claims for injuries or deaths and agree to permit the Player to be transported by a coach, parent or agent to or from any athletic or extracurricular activity, sponsored by Methacton Athletic Association. Father’s/Guardian's Name:______________________________ Mother’s/Guardian’s Name:_____________________________ Signature:____________________________________________ Signature:___________________________________________ Home Phone:_(____)___________________________________ Home Phone:_(____)___________________________________ Work Phone:_(____)________________________Ext.________ Work Phone:_(____)_______________________Ext._________ Cell Phone:_(____)_____________________________________ Cell Phone:_(____)_____________________________________ E-Mail (print clearly): ___________________________________ E-Mail (print clearly):___________________________________ Player’s Home Address: _______________________________________ Player’s Address Applies To: ( ) Both Parents City /State / Zip:__________________________________________________________________________ ( ) Father Only Second Parental/Guardian Address (if different from above):_____________________________________________ ( ) Mother Only 2012 Registration Fees $150 per player Registration questions contact: League President Chuck Eppolito (610) 584–5884 Mark your calendar for Player Evaluation, Saturday March 3 – Snow date March 10 at Arcola Middle School. All players make a team! You will be contacted later by phone for more details. MAA Use Only I have examined this applicant and the required supporting information and found each to be in accordance with MAA Baseball Rules & Regulations. MAA Official:__________________ Date:________________ Amount Due:___________ Amount Received:___________ Check#:________ MAA BASEBALL–COMMUNITY BASEBALL-13 YR OLD JR AMERICAN LEGION BASEBALL-13-15 YR OLD JR AMERICAN LEGION BASEBALL |
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