BYBL 2004 REGISTRATION FROM
Print and Mail to:
Blackford High School
BYBL
St. Rd 3 North
Hartford City, IN 47348
(Please enclose $30 for cost of the league)
Registration Form
Parent Consent
I/We acknowledge that the participant is assuming a certain risk of being injured: that even the best coaching and strict observance of the rules, injuries may occur. Blackford High Schools, the staff, and anyone else affiliated with the BYBL are not responsible for such injuries, participants will be covered by the participants family insurance. I hereby grant camp staff to have my daughter treated by a staff member or by a physician if necessary. My/our daughter is physically fit, according to our family physician.
Parent Signature of Release. _____________________
Date__________
Participants Name___________________________ Parent/Guardian_________________
Address__________________________
_________________________________
Phone #_________________________
Emergency #_____________________ Family Doctor____________________
Age_____ Grade_______
(Youth) S(6-8)___ M 10-12) ___ L(14-16)___
I am willing to help as:
_________Team Coach
_________ Scorekeeper
Skills Workshop: Saturday, December 4th at Northside
Grades 1 & 2: 4 - 5:30 PM Grades 3 & 4: 2:30-4:00
Registration deadline November 26th. Team assignments will be announced on December 4th at the workshop.
Grades 1 & 2 will be co-ed Grades 3 & 4 will be for boys.