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THOMASTON-UPSON COUNTY RECREATION
& PARKS DEPARTMENT YOUTH
PARTICIPANT REGISTRATION FORM Softball
Name
________________________________________________________________________ Mailing
Address ____________________________________
City ______________________
Telephone
___________________________ Date of
Birth _______________ Age
_________ Male
_____ Female ______ Grade
____________ School
_____________________________ Team
Played on Last
Year________________________________________________________ Parent's
Name _________________________ Email
Address: ___________________________
Business
Telephone: Father ________________________ Mother
________________________ Home
Telephone: Father _________________________ Mother ________________________ Doctor
________________________________________
Telephone
_____________________
Child's Physical
Condition
____________________________________________________ (List any physical
or mental handicaps or diseases such as epilepsy, heart murmur, rheumatic
fever, etc. which your child may have or any other special medical
information which may affect your child's participation). All
Participants please select shirt size: Please select SHIRT SIZE:
YS YM
YL AS AM
AL AXL A2X ************************************************************************* The Thomaston-Upson Recreation Department would like to notify parents/guardians that photos of individual players or teams will be taken for our sponsors and promotional projects. I/We, the above parents of the above named child, hereby give my/our approval for their participation in activities during the current season. I/We assume all risks and hazards incidental to the conduct of the activities and transportation to and from activities. I/We do further hereby release, absolve, indemnify and hold harmless the Thomaston-Upson County Recreation Commission, Recreation & Parks Department, the organizers of the activity, sponsors, supervisors any or all of them. In case of injury to my/our child, I/We hereby waive all claims against the organizers, the sponsors, or any of the supervisors appointed by them except to the extent covered by insurance. I/We do certify that our ward is covered by group accident or other comparable insurance. I/We, the parents of
the above named child, hereby give my/our permission to the person in charge
of the activity to take my/our child to the doctor or hospital in case of
injury. I/We understand I/We will be
responsible for any and all cost incurred by emergency transportation or
medical treatment provided.
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