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(Click below for .pdf file) Application to Play Little League Challenger Division APPLICATION TO PLAY LITTLE LEAGUE CHALLENGER DIVISION – 2010 (Please print) Player’s name:______________________________________________________________ Age:_____________ Address_________________________________________________________________________________________ City:__________________________________________ State:___________ Zip:____________________ Home Phone:___________________________________ Cell Phone:_________________________________ E-mail Address:__________________________________________________________________________________ Parent/Guardian:_________________________________________________________________________________ (Name) (Relationship) (Phone #) Emergency Contact:_______________________________________________________________________________ (Name) (Relationship) (Phone #) New Player:______________________________ Returning Player:_____________________________ I/We, the parents/guardian of the above named player candidate, give my/our approval for his/her participation in all Little League activities and transportation to and from the activities. I/We know that participation in baseball may result in injury and that 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 Inc, the organizers, sponsors, supervisors, participants, and person transporting my/our child, whether the result of negligence or any other cause, except to the extent and in the amount covered by accident or liability insurance. I/We agree to return any equipment issued to my/our child in good or fair condition, and I/We agree to follow the helmet rule established by the league. Parent(s) or Guardian Signature:_____________________________________________________________________ _____________________________________________________________________ Please indicate any
physical limitations (allergies, hearing, vision,
etc.):______________________________________ Accident insurance:_______________________________________________________________________________ If you do not want another shirt and hat and want to use last year’s uniform, registration is $10.00. Otherwise the cost is $15.00 for a shirt and hat. Shirt size (circle ONE): Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult XXLPlease attach check made out to Challenger Little League. Contact us at molinechallengerleague@gmail.com
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