Player Name *

First Name

Last Name

Player Date of Birth *

MM

DD

YYYY

What position(s) did you play? *

Pitcher

Catcher

1st

2nd

3rd

Shortstop

Outfield

Parent Name (1) *

First Name

Last Name

Parent Phone (1) *

(###)

###

####

Parent Name (2)

First Name

Last Name

Parent Phone (2)

(###)

###

####

I/we the Parent(s) or Guardian(s) of the above named candidate for a position on the Waverly Riptide Team hereby give my / our approval to participate in any and all Waverly Riptide Activities including transportation to and from activities. * *

Yes

No

I/we know that participation in baseball may result in serious injury and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify and agree to hold harmless the Waverly Riptide Baseball organization. *

Yes

No

I / we have our own health insurance. *

Yes

No

Makeup tryout date request.

Every effort should be made to participate in the tryout dates listed. If you absolutely cannot make the scheduled date and time enter information regarding your request. A coach will be in contact with you on possible tryout dates/times.

MM

DD

YYYY