WEST PLAINS YOUTH BASEBALL AND SOFTBALL
2006 REGISTRATION FORM
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THE WEST PLAINS PARKS AND RECREATION DEPARTMENT AND THE YOUTH BASEBALL WILL OFFER THE NBC "HAP" DUMONT YOUTH BASEBALL PROGRAM FOR BOYS AND ASA SOFTBALL PROGRAM FOR GIRLS DURING THE 2001 SEASON. ELIGIBLE PLAYERS MUST BE AT LEAST SEVEN YEARS OLD BY AUGUST 1ST BUT NOT OLDER THAN FIFTEEN.

THIS FORM AND A $20.00 PLAYER FEE MUST BE TURNED IN BEFORE FRIDAY, April 10th . ANY LATE REGISTRATIONS WILL BE PLACED ON A WAITING LIST AND ADDED TO EACH TEAM IF SPACE IS AVAILABLE. THE REGISTRATION FORM AND PLAYER FEE MUST BE TURNED IN BY April 10th AT THE WEST PLAINS OFFICE .

FOR INFORMATION ABOUT THE PROGRAM, REGISTRATION CALL JIM HAWKINS, SPORTS COORDINATOR @ 256-7304 AT THE WEST PLAINS PARK OFFICE.

PLAYER REGISTRATION

NAME:       DATE OF BIRTH:      BOY   GIRL

CHOOSE AGE BY AUGUST 1ST:    7     8     9     10     11     12     13     14     15       CURRENT GRADE:

ADDRESS & CITY:

NAME OF PARENT/GUARDIAN:

HOME PHONE: ()      BUSINESS/DAYTIME PHONE:()

MY CHILD HAS PERMISSION TO PARTICIPATE IN THE YOUTH BASEBALL/SOFTBALL PROGRAM, AND I WILL NOT HOLD ANYONE ASSOCIATED WITH THE PROGRAM RESPONSIBLE IN CASE OF ACCIDENT OR INJURY INCURRED DURING PLAY OR OTHER ACTIVITY CONNECTED TO THIS PROGRAM.

PARENT/GUARDIAN SIGNATURE: ___________________________________________________________
NOTE: REGISTRATION NOT ACCEPTED WITHOUT SIGNATURE

VOLUNTEER INFORMATION

COMPLETE THE FOLLOWING INFORMATION IF YOU ARE ABLE TO HELP SUPPORT THE WEST PLAINS PARKS AND RECREATION PROGRAM.

NAME:

HOME PHONE: ()      BUSINESS PHONE:()

ADDRESS & CITY: (IF DIFFERENT THAN ABOVE)

I CAN COACH A TEAM     AGE GROUP:     I CAN ASSIST A TEAM

I CAN SPONSOR A TEAM (OR PROVIDE A TEAM SPONSOR)
   SPONSOR NAME:     PHONE:
   ADDRESS:     NAME:

I AM INTERESTED IN HELPING THE BOOSTER CLUB OR SERVING AS A BOARD MEMBER

I AM INTERESTED IN UMPIRING OR SCOREKEEPING     AGE GROUP: