REGISTRATION FORM
 

Name:

_________________________________

Grade:

__________

Age:

___________

Address:

____________________________

City/State/Zip:

_____________________

Parent(s) Name:

_________________________________________________________

Phone:	Home:	________________________	Work:	____________________________
	Pager:	________________________	Cell:	____________________________

Position(s) you play:

_____________________

League:

_________________________

Emergency Contact:

_____________________________

Phone:

__________________

WAIVER OF CLAIMS:  I, the undersigned, as the parent or legal guardian of minor child, _____________________, hereby acknowledge that the forenamed child is covered by medical insurance as follows:
Insurer: __________________Company:_______________Policy #:_______________
It is further understood that the Texas Aces, Pearland Girls Softball Association, or Pearland Dad's Club do not provide medical insurance covering injuries of any nature incurred at the 2002 Texas Aces Softball Camp.  The undersigned hereby releases all claims, demands, and causes of action whatsoever in any way growing out of or resulting from participation of the forenamed child in the 2002 Texas Aces Softball Camp.

________________________________
Parent(s)/Guardian Signature

________________________________
Date

Return to:
Texas Aces Softball
c/o Kimberly Orsak
1935 Prairie Creek
Pearland, TX 77581

Questions:
Kim Orsak 281-997-9794
email: orsak5@aol.com

For more information about the 12U Texas Aces, visit www.texasaces.com/aces12u/.