Spring Registration Form

If you would like to help please check your preference

Players Name:*
Please enter your Players Name.

Address:Please enter your Address.

City:Please enter your City.

State:ALAKASAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip:
Please enter your Zip.Please enter zip code in the format ##### or #####-####

Home Phone:Please enter a real phone number in the format ###-###-####

Work Phone:Please enter a real phone number in the format ###-###-####

Parent / Guardian:

Email:*
Please enter your email address.
-- Not a valid EMail --
-- Must be in someone@somewhere.com format --

Gender:Please Select Gender of PlayerMaleFemale
Please select Gender.

Birthday:

Age:

School:

Diagnosis:

Do you require Special Needs/Requirements:

Players Shirt Size:Please Select a SizeYouthSmallMediumLargeX-Large
Please select a size.

Adult Shirt Size:Please Select a SizeSmallMediumLargeX-LargeXX-Large
Please select a size.

I give authorization for my child to participate in The Miracle League of East Texas, And do hereby released of any liability for injury that may occur while participating as a player or spectator during the season. Parent and/or Guardian must be present at all Miracle League games and/or events.

I hereby grant the Miracle League of East Texas, its affiliates, franchises, advertising and promotional agencies, and their agents, the irrevocable, unrestricted right to use, publish, display and distribute materials bearing my name, voice, likeness or any other identifiable representation of myself, my family members including my Miracle League player/child. These materials may appear in any form, style color or medium whatsoever (including, without limitation, photographs, video tapes, films sound recordings, software, drawings, prints, broadcast, internet and electronic media.) I agree that all material containing any identifiable representation of me (including without limitation, all negatives, plates and masters of any photographs, files, prints or tapes) shall be and remain the sole and exclusive property of the Miracle League.I hereby release and forever discharge the Miracle League from any and all liability and damages relating to the use of my name, voice, likeness or any other identifiable representation of me.I hereby waive any right I may have to inspect or approve the finished materials or any part or element there of that incorporates my name, voice, likeness or any other identifiable representation of myself, my family including my Miracle League player/child.I have agreed to the above in consideration of the opportunity given to me by The Miracle League of East Texas to appear in these materials. I acknowledge that I have fully read and understand this document and that I have had any questions regarding its effect or the meaning of its terms answered to my satisfaction. I certify that I am at least 18 years of age, unless this document is also signed by my parent or legal guardian.

IF FINANCIAL ASSISTANCE IS NEEDED PLEASE MARK THIS BOX

Every child deserves the chance to play baseball.

This check box will represent your electronic signature agreeing to all terms and conditions contained on this form

Please accept the terms...