GREENVILLE CITIZENS BASEBALL LEAGUE INCORPORATED 2013 PLAYER APPLICATION

PLAYER MAY NOT PLAY IN ANY OTHER LEAGUE OR ORGANIZATION DURING LEAGUE OR TOURNAMENT PLAY. NO EXCEPTIONS!!! LEAGUE IS OPENTO ALL KIDS IN DARKE COUNTY. PLAYER MUST BE 3 YEARSOLD AND NO OLDER THAN 12 ON JUNE 1, 2013. APPLICATION MUST BE RETURNED TOSCHOOL BY FEBRUARY 22NDOR MAILED TO 108 SHAWNEE ST GREENVILLE, OH 45331 BY MARCH 2ND. WE WILL ALSO HAVE A SIGN UP DAY AT THEBALLPARK ON MARCH 2 FROM 10-NOON. MARCH 2NDISTHE ABSOLUTE DEADLINE FOR APPLICATIONS. THE FEETO PLAY IS $50 OR PLAYERMUSTSELL FUNDRAISER EQUIVALENT. DO NOT MAIL CASH. CHECKSSHOULD BE MADE OUT TO GCBL. YOU MAY ALSO PAY THE FIRSTTIME YOU MEETYOUR COACH. WE WILL PROVIDE HAT, SHIRT, SOCKSAND PANTS. PANTS MUST BE TURNED BACK IN AT THE END OF THE SEASON.

NAME _ DATE OF BIRTH _ AGE AS OF JUNE 1,2013__

PARENT/GUARDIANS NAME _ PHONE NUMBER _ADDRESS _

EMAILADDRESS _

EMERGENCYNAMEANDPHONENUMBER _

LEAGUE (CHECK ONE)

LITTLE SLUGGER (3 &4 TEE ONLY) _ T-BALL (5&6 COACH PITCH & TEE) _

MINI-BALL (7&8 COACH PITCH) _ INTERNATIONAL (9&10 KID PITCH) _

ASSOCIATION (11&12 KID PITCH) _

IF YOU WOULD LIKE THE PLAYERTO PLAY AN AGE GROUP UP OR DOWN FOR ANY REASON PLEASE CONTACT KEITH HEIDRICH AT (937) 760-2008.

SHIRT SIZE _ SCHOOLATTENDED _ DID YOU PLAY GCBL IN 2012? _

DID YOU PLAY ORGANIZED BASEBALL LAST SEASON BESIDESGCBL? WHICH TEAM? _

DO YOU HAVE A SIBLING IN THE SAME LEAGUE? IF YES, WHO? _

PARENTS ARE THE STRENGTH OF OUR PROGRAM. PLEASE INDICATE WHERE YOU CAN HElP YOUR TEAM

HEAD COACH _ ASSISTANT COACH TEAM PARENT _ CONCESSION HELPER _

TO ENSURE SAFETYAND WELL-BEING OF ALL YOUTH PARTICIPATION IN GCBL, WE WILL BE CONDUCTING BACKGROUND CHECKSON ALL COACHESAND ASST COACHES. CHECKS WILL BE DONE THROUGH DARKE COUNTY SHERRIFF DEPARTMENT.

QUESTIONS CAN BE DIRECTED TO KEITH HEIDRICH, GCBL COMMISSIONER AT (937)760-2008 OR keith.heidrich@yahoo.com.

I, THE UNDERSIGNED PARENT/ GUARDIAN OF AGREE NOT TO HOLD THE TRUSTEES, OFFICERS,COACHESANDALL OTHER PERSONSAFFILIATED WITH GCBL OR DARKE COUNTY YMCA LIABLE FOR ANY ACCIDENTS OR INJURIES THAT MAY OCCUR TO MY CHILDDURNG PRACTICES, LEAGUE, AND TOURNAMENT GAMES OR ANY OTHER ACITIVITYTHATTAKES PLACEAT SATER PARK OR OTHER LOCATIONSAPPROVED BY GCBL. I ALSO AGREE TO ABIDE BY ALL RULESAND REGULATIONS SET FORTH BY GCBL, THE OHIO HIGH SCHOOL ATHLETICASSOCIATION, AND COACHES OF TEAMS. I AGREE TO BE HELD RESPONSIBLEFOR ALL EQUIPMENT HADED OUT BY GCBL, INCLUDING RETURN OFTHE PANTS. FAILURE TO DO SO MAY RESULT IN INELIGIBILITY.

SIGNATURE OF PARENT/GUARDIAN _

www.greenvillebaseball.net

MEDICAL CONSENT FORM AND EMERGENCY INFORMATION

IN THE EVENT OF AN EMERGENCY: I, THE PARENT / GUARDIAN OF______________ CONSENT TO HAVE HIM/HER

TRANSPORTED TO THE NEAREST HOSPITAL BY LOCAL RESCUE AND TREATED BYTHE DOCTOR ON CALL. I CAN BE REACHED AT OR

SIGNATURE OF PARENT/GUARDIAN DATE__

ANY MAJOR ILLNESS, INJURIES, ALLERGIES, OR RESTRICTIONS?

IS THERE ANY OTHER ADDITIONAL INFORMATION THAT WILL HELP COACH YOUR

CHILD?

WWW.greenviliebaseball.net

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