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Snake River Valley Babe Ruth Baseball
SRV Elks Babe Ruth
Elks Lodge 1690
Registration Form 2014
Babe Ruth 13 14-15 Shirt Size: Circle One
S M L XL
Hat Size: S/M M/L L/XL
You must fill out one form for each player that is participating in SRV Elks Babe Ruth.
As a parent or legal guardian of _________________________________ I agree to pay the registration fee of $80+ fee online or $85 check/cash, which covers insurance, a shirt and a hat for each player. Registration fee must be paid before the player may participate in practice or games. Insurance will have a $100 deductible per incident.
Players Name: _____________________________________ Birth Date: ______________ Age: ________
Address: ______________________________________ City: ________________ Zip: _______________
Home Phone: _______________________________ Cell Phone: ________________________________
Parent/Guardian Signature: ________________________________ Relationship: ____________________
Payment Type: Cash _______ amount
Check _______ amount
_______ Ck. Number
Would you or someone you know be interested sponsoring a player that has financial need? If yes, please fill in name and contact information. Name:_________________________ Phone: ____________________
Will you allow your child’s picture to be published on the league website? Yes No (please circle one)
Consent for Treatment
Please complete and sign the consent for treatment form below.
Player Name: _________________________________ Phone: _____________________
Home Address: ____________________________ City: ______________ State: _______
Family Physician: ________________________ Dr. Phone #: _____________________
List of allergies: ___________________________________________
Required Medications: ______________________________________
Blood Type: _________ Other Conditions: _______________________
League Insurance Policy #: ___________________________________
League Group Policy #: ______________________________________
In case of emergency or illness, I hereby authorize a representative of Babe Ruth Baseball
to use his/her judgment in obtaining immediate medical care.
Date: ___________________ Signature: ____________________________________________
(Parents will be notified in case of serious illness or injury, but this consent will allow for immediate treatment.)
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