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Current Team ______________
REGISTRATION APPLICATION FOR THE
MID COUNTY SENIOR BABE RUTH LEAGUE
Player________________________________________________
Address_______________________________________________
Date of Birth_________________________________________
Phone_________________________________________________
Parent or Guardian____________________________________
Family Physician______________________________________
Any allergies. If none, so state._____________________
I am the parent or legal guardian of the above named child, who is under the age of 18 years, and I do hereby consent for him to participate and compete in the Mid Count Senior Babe Ruth League summer program. I hereby release the Mid County Senior Babe Ruth League, its successors and assigns, and all its officials, directors, organizers, sponsors, supervisors, coaches, employees, participants, personnel, legal representatives, and persons transporting my child to and from league activities from any and all claims or liability, present and future, known or unknown, in any manner arising out of property damage and/or personal injuries sustained by me or my child as a result of his competing and participating in games, practices or other activities sponsored by, or utilizing equipment or facilities owned, used or leased by the Mid Count Senior Babe Ruth League.
If my child is injured, I give my permission and consent for him to be carrier to a hospital and given treatment by any physician, clinic, or hospital, and his or its personnel, and hereby release said physician, clinic, hospital and his or its personnel for injury or damage incurred by my child while being treated or transported to a hospital, clinic or physician’s office and while being administered necessary medical treatment. In addition, I agree to indemnify and hold harmless the Mid County Senior Babe Ruth League, its successors and assigns, and all its officials, directors, organizers, sponsors, supervisors, coaches, employees, participants, personnel, legal representatives, and persons transporting my child to and from activities, against any loss from any and all claims, demands or actions at law or in equity, including attorney’s fees, that may hereafter, at any time be made or brought by the above named child or anyone on his behalf, whether reduced to judgement or not, for the purpose of enforcing any claim in any manner arising out of property damage and/or personal injuries sustained by the child as a result of his competing and participating in activities sponsored by or from utilizing equipment or facilities owned, used or leased by the Mid County Senior Babe Ruth Baseball League.
Further, in consideration for the Mid County Senior Babe Ruth League, providing athletic equipment, facilities, and competition, along with transportation to and from certain activities involve the risk of injury or damage to the person or property of another by the intentional or negligent acts of my child, I do hereby contract, covenant and agree to indemnify and hold harmless the Mid County Senior Babe Ruth League, its officials, directors, sponsors, supervisors, coaches, employees, participants, or persons transporting my child to and from activities for any loss which it may sustain by virtue of, or as the result of, my child’s negligent or intentional conduct which causes injury, loss or damage to himself or the person or property of another. I also agree by signing this document and requesting that my child be allowed to compete and participate that I will be responsible for any damage, injury or loss sustained by the League by virtue of my child failing to return in good condition or for destroying equipment or uniforms issued to him.
I further assume full monetary responsibility, in the event while on a traveling tournament team, my child accidentally or intentionally causes damage to the hotel/motel room, property, furnishings or equipment owned or leased by said hotel/motel. The player or players responsibility for these damages will be disqualified and returned home immediately. Failure to agree to the terms and conditions of the Mid County Senior Babe Ruth League will prevent a player from being selected to any All-Star tournament team.
Finally, I recognize and acknowledge that the Mid County Senior Babe Ruth League does not assume responsibility for medical treatment or any injury suffered by my child other than for providing insurance for accidental injury suffered as a direct result of athletic competition or practice and that the Mid County Senior Babe Ruth League does not provide liability or medical insurance coverage other than the emergency medical treatment for the above listed injuries and that if I desire expanded accident, medical or liability coverage that it is my responsibility to provide it.
I AFFIRM THAT I HAVE READ AND INDERSTAND THE ABOVE PARAGRAPHS AND AGREE TO THEIR TERMS AS A NECESSARY PRE-CONDITION TO MY CHILD’S PARTICIPATION IN THE MID COUNT SENIOR BABE RUTH LEAGUE ACTIVITIES.
__________ _______________________________
Date and Signature of Parent or Guardian
Note: No application will be accepted, nor will a player be allowed to try out without registration fee and completed and signed registration and medical information forms.
*Registration Fee: 1 Player $75.00 2 or more Players $ 100.00 Hardship Cases Available
Any questions you may call
Jimmy Collins 350-1745
Hollis Whorton 781-8577
Clint Landry 893-3598
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