ONLINE REGISTRATION FORM
Child's Name:
First Name, Last Name
Please select the appropriate league age:
Please select one...
Born between 5/1/95 and 4/30/96: League Age 12
Born between 5/1/96 and 4/30/97: League Age 11
Born between 5/1/97 and 4/30/98: League Age 10
Born between 5/1/98 and 4/30/99: League Age 09
Born between 5/1/99 and 4/30/2000: League Age 08
Born between 5/1/2000 and 4/30/2001: League Age 07
Born between 5/1/2001 and 4/30/2002: League Age 06
Born between 5/1/2002 and 4/30/2003: League Age 05
Registering For:
T-Ball (age 5-7)
Farm League (6-8)
Minor League (7-11)
Major League Tryout (9 and over)
Major League Returning (already on a Major's team)
Other spring sports:
Please list any Physical limitations (allergies, hearing, sight, etc,)
Age:
D.O.B.
Sex:
M
F
Height:
Grade:
Pre-K
K
1
2
3
4
5
6
7
8
9
10
11
12
School:
Charter
Chilmark
Edgartown
Oak Bluffs
Pre-School
Tisbury
West Tisbury
Shirt Size:
adult small
adult medium
adult large
Parent's Name:
E-mail:
Parent Volunteer:
coach
assistant coach
bench parent
other
no thank you
Mailing Address:
Town of
Aquinnah
Chilmark
Edgartown
Oak Bluffs
Tisbury
West Tisbury
State:
MA
Zip:
02568
02557
02539
02535
02575
Home Phone:
Cell Phone:
Emergency Contact:
Phone:
Medical Insurance
Insurance Name:
Insurance Number:
I/We the parents of the above named candidate for a position on a little league team, hereby give my/our approval to participate in any and all little league activities including transportation to and from activities. I/We know that participation in baseball my result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve ,indemnify ,and agree to hold harmless the local little league, Little League baseball incorporated, the organizers ,sponsors ,supervisors ,participant , and persons transporting , 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 Agree to return upon request the Uniform (Little League majors Shirts, Belts) and other equipment issued to my/our child in as good a condition as when received except for normal wear and tear.
I hereby give my son/daughter permission to attend the Martha’s Vineyard Little League Program.
please check to indicate permission
In case of any accident to your child, all efforts will be made to contact the immediate family. If we are unable to do so and emergency medical assistance is needed, we would like to have your permission to proceed with aid. Some hospitals refuse treatment without parental consent.
As Parent or Legal Guardian of the above named player, I hereby give my consent for the emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well being of my dependent.
please check to indicate permission
Type your name as your signature:
Date:
Special Requests:
We will make every effort
to accommodate requests but cannot
guarantee them.
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