Registration Ross Valley Little League Fall 2008
Registration Information: Step 2 of 3  



Registration is not complete until payment has been made. You will receive a confirmation number after completing the first registration step. This number must be used to properly credit your payment. The payment page will come up after you have completed the first step and the confirmation number will automatically be entered.

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	First Name*:	Middle Initial:
	Last Name*:
	Mailing Address*:
	City*:	State*: Zip*:
	Email*:
	Phone*:
	Date of Birth* (MM/DD/YY):	Gender: Select Male Female
	Grade*:	Select 1 2 3 4 5 6 7 8 9 10 11 12 School*: Select Bacich Elementary Brandeis Hillel School Kent Middle School Marin Catholic Marin Country Day School Marin Primary Mt. Tam School Redwood High School Ring Mountain Ross School San Domenico St. Anselm's St. Mark's St. Patrick's Other Specify:
	Levels of Play:	Rookies to Minors - Played Rookies or first time in a league - 9 year olds "next year" who will most likely play first year in Minors during Spring 09 Returning Minors 2nd year - Played one year of Minors - 10 year olds for Spring 08 who will most likely be back in Minors in 4th grade Minors to Majors - Most likely played two years of Minors and/or will be in 5th grade this fall, moving up to Majors 11 year olds for Spring 09 Returning Majors - Played 1st year as Major this past season, most likely 12 year olds for Spring 09 Majors to Juniors & Returning Juniors - returning Juniors 2nd year Majors moving up to play 13, 14 years old Spring 09
	League*:	Select Rookies to Minors Returning Minors 2nd yr Minors to Majors Returning Majors 2nd yr Majors to Juniors, Returning Juniors
	Parent1 Name*:
	Parent1 Email*:
	Parent1 Phone*:
	Parent2 Name:
	Parent2 Email:
	Parent2 Phone:
	Emergency Contact*:
	Emergency Phone*:
	Health Plan*:
	Plan Number*:
	Doctor*:
	Dr Phone*:
	Medical Issues:
	Previous Injuries:
	Approval to Participate, Consent for Medical Treatment, and Release and Waiver
		Approval to Participate I/we, the parent/legal guardian(s) of the player identified above (the "Player"), hereby give my/our permission and consent for the Player to participate in any and all activities of the Ross Valley Little League (the "RVLL"). Wavier of Liability and Assumption of Risk I/we understand and I/we acknowledge that RVLL activities have inherent risk and may result in serious injury, or even death. I/we, hereby on my/our behalf and on behalf of the Player, expressly assume any and all risks and hazards directly or indirectly incidental to participation in RVLL activities, including transportation to and from any RVLL activities. I/we, hereby on my/our behalf and on behalf of the Player, expressly waive, release, indemnify and agree to hold harmless, defend and indemnify RVLL, Little League Baseball, Inc. ("Little League"), and all sponsoring organizations, sponsors, organizers, administrators, participants, coaches, managers, assistants, or other representatives, including any and all persons or groups providing transportation to and/or from any RVLL activities, and against any and all claims, demands, or lawsuits directly or indirectly arising from participation in any RVLL activities. I/we, hereby on my/our behalf and on behalf of the Player, agree to abide by the rules of the RVLL and Little League, and further to return all RVLL equipment and uniforms in acceptable condition or to be financially responsible for same. I/we understand that, in accordance with the established rules of RVLL and Little League, RVLL reserves the right to suspend players for breach of these rules. I/we, understand that RVLL reserves all rights and powers as to team assignments for each player, based on its sole discretion of what is best for each player and the RVLL as a whole. I/we, attest that (1) the mailing address set forth on the Registration Information page and (2) the birth date set forth on the Registration Information page are true. I/we also understand that an original birth certificate and evidence of residence of the Player must be on file with the RVLL. I/we, hereby on my/our behalf and on behalf of the Player, hereby waive any and all rights to any photographs, video tapes, digital images, video tapes, motion pictures, recordings, or any other record of the activities which may be made by the RVLL, Little League and/or affiliate organizations. Consent to Medical Treatment I/we authorize RVLL or it representatives, as agent to the undersigned, to give consent for emergency medical care prescribed and deemed advisable by a duly licensed physician, dentist or emergency medical technician. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of the Player. This authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the party of my/our agent to give specific consent to any and all diagnosis, treatment or hospital care which the physician, dentist or emergency medical technician in the exercise of his/her best judgment may deem advisable. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California, will be applied to emergency care only, and shall remain effective until revoked in writing. Name of person completing this form: It is my/our intent that this "Approval to Participate, Consent for Medical Treatment, and Release and Waiver" remain in full force and effect at all times. This document may be referenced in all future registration forms that may be submitted for my/our child's participation in RVLL activities, particularly those that may be submitted electronically. By clicking here I am signing this document.