LYA Girl’s Softball

Your Name:

Your Email:

Child's Name:

Your Address:

Phone:

Cell Phone:

Grade:

Team Last Year:

Shirt Size:

School:

Emergency Contact:

Emergency Phone Number:

Allergies:

Physician:

Hospital:

Medical or other information we should know about your child:

Parent’s Name:

Parent’s Phone:

Parent will help with coaching?

 Yes, No

I give my child permission to participate in the LYA Softball League.

 Yes No

I give the LYA permission to take pictures of my child while participating in the LYA Softball League. This photo may be used in LYA brochures or on our website.

 Yes, No

Parent Digital Signature:

Date:

Complete Registration form and then hit Send. Your registration will not be final until payment has been made.

Registration fee is $45 per child

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