2017 Fall Ball Registration
2017 Fall Ball Registration Form
Medical and Liability Release
I, the parent/legal guardian of the above-named player, a minor, or a player age 18 or over, agree that I and the player will abide by the rules and regulations of Little League, and its affiliated organizations, and Willow Glen Little League. I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the Little League and Willow Glen Little League, the owners and operators or the facilities used for the programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player’s participation in the Programs including, without limitation, player’s transportation to/from any Program, which transportation is hereby authorized. I further grant Little League and Willow Glen Little League the right to use player’s name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player’s status as a participant in the Programs.
As the parent/legal guardian of the above-named player, or player age 18 or over, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of me or my dependent.
I understand that if this player has been registered and rostered on a team with any Little League and Willow Glen Little League at any time during this seasonal year that unless he/she transfers off that team, this player may not be rostered on any other Little League and Willow Glen Little League. Being concurrently rostered on two different Little League teams and/or providing false or misleading information may be cause for the player and/or team to be disqualified from any and all Little League and Willow Glen Little League games in which the player participated and the player and/or team may face additional disciplinary action(s).
is due with completion of the form.