Medina Assembly Baseball League

Registration 2010

Fee: $40 (2 children $70) (max. $80 per family)

(*Required Fields)   

* Last Name   

  *First Name 

          Boy       Girl

        *Address 

City   Zip

           *Phone

 * Date of Birth

        Email        

Mother's Name 

Father's Name  

*Choose One:

TBall ages 3-5 year oldsCoach Pitch 5-7 year oldsBoys Baseball 7-10Girls Softball 7-10

*To help divide the teams up evenly has your son/daughter ever played T-Ball, Coach Pitch, Baseball or Softball?  If so, for how many years?

    I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of Medina Assembly Baseball League.  Recognizing the possibility of physical injury associated with baseball and in consideration for Medina Assembly Baseball, against any claim by or on behalf of the registrant as a result of the registrant's participation in the programs and/or being transported to or from the same which transportation I hereby authorize.

   I accept              I do not accept

The Medina Assembly Baseball League is run by parent volunteers like yourselves.  Your participation is crucial for the continued success of this program.  Please volunteer for one of the following positions.  No experience is required for any position, just a love for kids and a positive attitude!

(Background Check is Required for the Safety of our children!)

 Coach             Assistant Coach   

           Name of Volunteer:

Any other information.  (ex. Allergies, medical conditions or comments)