NJJBA - 2007 Seniors League Registration

Player Information (all fields are required)

Last Name:	First Name:	Middle:
Address:	City:	Zip Code:
Phone:	Email:

Parent/Guardian Information (if any info is same as above, please put 'Same' or leave blank)

Name 1:		Relationship:
Alt. Phone:		Email:

Name 2:		Relationship:
Alt. Phone:		Email:

Eligibility Information (* indicates required field)

DOB *:		League Age *:
School *:		Other? Please Provide *:
High School Area *: (Can be defined via residence address or attending School)
Birth Certificate on file with NJJBA? YES NO (If No, a copy of State Certificate of Live Birth MUST be provided)

Player Registration Options (please select the appropriate option below)

	Option 1: I HAVE NOT played with North Jefferson Junior Baseball in the last two years (Copy of State Birth Certificate required)
	Option 2: I played for the following NJJBA team within the last two years (please provide as much information as possible):
	Coach:
	Team:
	Age Group:
	Division:
	Option 3: Last year I played for the following Seniors team and wish to continue to play with the same group:
	Coach:
	Team:
	Option 4: I am a member of a 2008 14-year-old NJJBA team that will be playing in the 2008 Seniors season "as a team":
	Coach:
	Team:

Additional Comments

Special Notice

The fee for NJJBA Seniors baseball is $165.00. No additional fees will be assessed. This completed form and your fees are due at the time of registration. Cap and jersey issue will occur after teams are formed. A cap and jersey will not be issued until this completed form and fees are accepted by NJJBA. If previously issued NJJBA equipment is outstanding, no cap and jersey will be issued until equipment is returned or paid for.

Release and Authorization

I/We the parent(s) or guardian(s) of the above named candidate for a position on a North Jefferson Junior Baseball Association (NJJBA) team, hereby give my/our approval to participate in any and all league activities. I/We understand that it is our responsibility to notify league officials of any change in medical conditions or concerns.

I/We know that participation in baseball may result in serious injury or death and protective equipment does not prevent all injuries to players and do hereby waive, release, absolve, indemnify and agree to hold harmless the NJJBA, Jefferson County Junior Baseball League, North Jeffco Parks and Recreation, City of Arvada, City of Westminster, Jefferson County School District, the organizers, sponsors, participants and persons transporting my/our child to and from activities for any claim arising out of injury to my/our child whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance.

I/We also grant permission to managing personnel to authorize and obtain medical and/or dental care or treatment from any licensed physician, hospital or medical clinic should my child become ill or injured while participating in any Association or League activities when neither parent nor guardian is available to authorize emergency treatment.

I certify that the person listed above is eligible, under the above stated conditions, to participate in the NJJBA Seniors Program.

By signing below, you hereby agree to the "Release and Authorization"

Parent/Guardian Signature:

Date: