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Mission & Vision
Registration
About
MLP Board of Directors
History
Calendar
Fundraisers
Clay Shoot Fundraiser
Golf Tournament
Annual Turkey Fry
Sponsors
Contact Us
Home
Mission & Vision
Registration
About
MLP Board of Directors
History
Calendar
Fundraisers
Clay Shoot Fundraiser
Golf Tournament
Annual Turkey Fry
Sponsors
Contact Us
Sample Page
Player Registration Form
Step
1
of
2
50%
PLAYER'S Full Name
(Required)
First
Last
Age
(Required)
Date of Birth
(Required)
Parent / Guardian's Full Name
(Required)
Email
(Required)
Address
(Required)
Mailing Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Cell Phone
(Required)
Home Phone
Work Phone
Player's Disability / Types of Assistance Needed
(Required)
Coach Requested (as available)
Which type of Buddy for your player
(Required)
Please Select
Adult
Older Child
Sibling
Parent
Uniform Shirt Size: (Choose One)
(Required)
Please Select
YOUTH Small
YOUTH Medium
YOUTH Large
YOUTH X-Large
ADULT Small
ADULT Medium
ADULT Large
ADULT X-Large
ADULT XX_large
ADULT XXX-Large
Please read and sign the following: As a parent / guardian I understand that I am to stay on the premises during my players’ games and practices. I have read the Expectations of Play and will comply with that set forth by the MLP Board of Directors. I also agree to participate in all MLP fundraisers (selling) in order to help maintain our affordable registration fees.
Signature of Parent / Guardian
(Required)
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Date
(Required)
MM slash DD slash YYYY
In consideration for the Miracle League of Northeast Pensacola. Inc. providing the opportunity for my child to participate inthe Miracle League Baseball, the undersigned does hereby release and agree to indemnify and hold harmless the Miracle League of Northeast Pensacola. Inc. and its officers and directors from any and all claims for personal injury. death, property damage, or any type of claim or damage (including but not limited to attomey’s fees or litigation expenses) resulting from my child’s activities in connection with participation in Miracle League baseball or the participation of any family member or guest of the undersigned I assume all risks and hazards incidental to such participation in Miracle League games and activities and consent for my child to receive first-aid and / or emergency care by a qualified Emergency Medical Technician or physician or other person qualified to render medical assistance in the event my child suffers an injury during sanctioned games and activities. I agree to provide my child’s specific medical information to the Miracle League of Northeast Pensacola. Inc. so that appropriate precautions and care can be provided to my child during sanctioned games and activities. I/We agree to be present at all games and activities so that I/We can manage our child’s specific needs. I agree to have any and all medication (prescription and non- prescription) for my child and shall be solely responsible for dispensing any such medication to my child. We agree to abide by all of the COVID-19 policies put in place and release Miracle League of Pensacola from all liability for unintentional exposure or harm due to COVID-19.
Parent/Guardian Signature
(Required)
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Date
(Required)
MM slash DD slash YYYY
I/We understand that there will be media and promotional coverage of Miracle League Games and activities and I/We give our consent to publish my/our child’s name and picture for such purposes. I hereby grant the Miracle League Association, its affiliates, franchises, advertising and promotional agencies, and their agents, the irrevocable, unrestricted right to use, publish, display and distribute materials bearing my name, voice. likeness or any other identifiable representation of myself. my family members. including my Miracle League player/child. These materials may appear in any form, style, color or medium whatsoever (including, without limitation. photographs, video tapes, films, sound recordings. software, drawings, prints. broadcast. internet and electronic mediaI agree that all material containing identifiable representation of me (including without limitation, all negatives, plates and mastersof any photographs. files. prints or tapes) shall be and remain the sole and exclusive property of the Miracle League Association I hereby release and forever discharge The Miracle League Association from any and all liability and damages relating to my name, voice. likeness or any identifiable representation of me. I hereby waive any right I may have to inspect or approve the finished materials or any part of element thereof that incorporates my name, voice, likeness or any other identifiable representation of myself, my family. including my Miracle League player/child. I have agreed to the above in consideration of the opportunity given to meby the Miracle League Association to appear in these materials.
Parent/Guardian Signature
(Required)
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Date
(Required)
MM slash DD slash YYYY
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Name on Back of JERSEY
(Required)
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Jersey Size
(Required)
Total
Payment Option
(Required)
Pay In Person
Please bring cash or check payment to registration days at the park.
I understand and agree that payment will be made upon arrival at the park.
(Required)
I understand and agree that payment will be made upon arrival at the park.
Player Registration
Signature
(Required)
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