Alb Player Registration Form

WASHINGTON STATE AMERICAN LEGION BASEBALL

PLAYER REGISTRATION FORM

This form is used for players and their families who wish to participate in the Washington State American Legion Baseball program. The questions we ask are used to complete the registration requirements for the State and National registration process. Some of the information is used to complete the Insurance forms that the teams carry with them so that if a player gets injured medical treatment is authorized if the parent is not available at the time of injury.

COMPLETE ALL QUESTIONS ON THE FORM AND THEN CLICK THE SUBMIT BUTTON

PLAYER INFORMATION - Use your full legal name!

First Name: A value is required. Middle Initial: Last Name: A value is required.

Home Address: A value is required. Apt/Unit:

City: A value is required. State: A value is required. Zip Code: A value is required.Exceeded maximum number of characters.Invalid format.

All phone numbers on this page need to be in this format: (000) 000-0000

Home Phone: A value is required.Invalid format. Cell Phone: Invalid format. Email Address: A value is required.Invalid format.

Date of Birth: This following date needs to match the date on your Certified Birth Certificate - do not use certificate of live birth.

Birth Date: A value is required.

What School do you attend: A value is required. What year will you graduate from HS: Please select a valid item.Please select an item.

Height/Weight: Feet: Please select a valid item.Please select an item. Inches: Please select a valid item.Please select an item. Weight: A value is required.Invalid format.Exceeded maximum number of characters.lbs -- Bats Right Left Please make a selection. Switch Please make a selection.Minimum number of selections not met.Maximum number of selections exceeded.

Throws: Right Left Please make a selection. Both Please make a selection.You Must Check A Throws Box.You Can Only Check One Throws Box. --- Do you pitch: RHP LHP Please make a selection. No Please make a selection.You Must Choose One Pitch Box.You May Only Check One Pitch Box.

Primary Position: A value is required.Secondary Position: A value is required.

TEAM INFORMATION

Did you play American Legion Baseball last year? Yes No Please make a selection, IYou Must Select Yes Or No.You May Only Check Yes Or No. If you played was it on a team in Washington State? Yes No Please make a selection.You Must Select Yes Or No.You May Only Check Yes Or No.

If you did play last in the Washington State, what team did you play for: Team Name:

What team will you try out for this year(if your team is not on the list choose other and fill out the box below): Team Name: Please select a valid item.Please select an item.

If the team you are trying for is not listed, enter the name and city/state of the team here:

PARENT/GUARDIAN INFORMATION

First Name: A value is required. Last Name: A value is required. Relationship to Player: A value is required.

Address: A value is required. Apt/Unit:

City: A value is required. State: A value is required. Zip Code: A value is required.Invalid format.

Home Phone: A value is required.Invalid format. Cell Phone: A value is required.Invalid format. Email: A value is required.Invalid format.

PRIMARY INSURANCE INFORMATION - This information is requried in case the player is injured and the parent or guardian is not available and the player needs medical treatment.

Is the person above covered by a medical insurance policy? Yes No Please make a selection.Minimum number of selections not met.Maximum number of selections exceeded. -- If yes please complete the following information

Medical Insurance Company: Policy Number:

Family Physician: Physicians Phone Number: Invalid format.

Emergency Contact Person: Phone Number: Invalid format.