OLIVER SPRINGS YOUTH CLUB
Baseball/Softball Sign-up
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Paid______________
Cash_____________
Check #___________
Other_____________
Receipt #________________
I, the undersigned, hereby give permission for
______________________________________ ____________________________________
Child's Name Date of Birth (Must be 5 on or before May 1st)
To participate in the baseball/softball program offered by the Oliver Springs Youth Club. Furthermore, I
hereby relieve OSYC, the Tri-County Little League, and the USSSA of all liability, including medical
expenses, should the above named child incur any injury while participating in, traveling from, prior to, and
immediately after any and all scheduled Oliver Springs Youth Club approved events (games, scrimmages,
practice sessions, etc.). I further agree to reimburse OSYC the replacement cost for any and all items lost,
stolen, and or otherwise rendered unusable (as determined by the OSYC) that are issued to the child for
participation in this program. I further relieve OSYC of any responsibilities from the loss and or theft of any
and all personal items and equipment.
*When signing this form, you as a parent or guardian will be required to work a ONE HOUR
MINIMUM in the concession stand or gate before or after your child's game AND will try to help
out when needed. With out the concession stand revenue, we will NOT have adequate funding
to maintain our program. Your child's coach or a concession stand representative will have
sign-up sheets to help you choose a time to fit your schedule.
SIGNATURE OF PARENT OR GUARDIAN:__________________________________________DATE:_________________
Father's Name (or guardian):__________________________________Email address:__________________________
Address:_______________________________________________________________________________________
Home Phone:________________________________________Cell Phone:__________________________________
Employer:___________________________________________ Work Phone:_________________________________
Mother's Name (or guardian):_________________________________Email address:__________________________
Address: (if different))_____________________________________________________________________________
Home Phone:(if different)_______________________________Cell Phone:__________________________________
Employer:___________________________________________Work Phone:_________________________________
Name, Address, & Phone Number of nearest relative not living with you_______________________________________
______________________________________________________________________________________________
*IF YOUR CHILD'S UNIFORM AND/OR EQUIPMENT IS NOT RETURNED:
1. Your child will not receive a trophy.
2. Your child will not be allowed to participate in the next session.
3. Your child will be responsible for the total cost of a uniform replacement, currently $60.00.
*If you are interested in assisting with a team, please check here:______________
*Do you have health insurance for your child? Yes______ No_______