Registration Ross Valley Little League Spring 2010
Registration Information: Step 2 of 3  

Please fill in all of the requested information and make your selections below. After completing the form, click the Submit button at the bottom of the page.

* denotes required information

	Player First Name*:
	Player Last Name*:
	Street Address*:
	City*:	State*: Zip*:
	Email*:
	Phone*:
	Date of Birth* (MM/DD/YYYY):	Gender: Select Male Female
	League Age on 4/30/10*:	Select 5 6 7 8 9 10 11 12 13 14 15 16
	Grade*:	Select PK K 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 If Other Specify:
	Age Rules:	T-ball - 5 to 6 Farm - 6 to 7 Rookies - 7 to 8 AND in 1st or 2nd grade Minors - 8 to 11 AND in 3rd grade or above Majors - 10 to 12 Juniors - 13 to 14
	Program Fees:	T-ball - $220 Farm - $220 Rookies - $250 Minors - $285 Majors - $285 Juniors - $325
	League Choice*:	Select T-ball Farm Rookies Minors - Mandatory Tryouts 1/23/10 Majors - Mandatory Tryouts 1/23/10 Juniors - Mandatory Tryouts TBD
	Team Requests (T-Ball and Farm only):
	2009 League:	Select T-ball Farm Rookies Minors Majors Juniors Seniors Did not play
	2009 Team:
	Parent1 Name*:
	Parent1 Email*:
	Parent1 Phone*:
	Parent2 Name:
	Parent2 Email:
	Parent2 Phone:
	Volunteer: (select all that apply)	Manager - will require Board approval Assistant Coach - will require Board approval Team Parent - Manager's discretion Snack Shack - Mandatory for Majors and Minors families
	Team Sponsorship:	$500 level - Signage at the Bacich Fields. - Print "Thank You" Ads in the Kentfield school directory. - A wall plaque with your team photo. - Your name embroidered on the hat of each player on your team. - Wall sign at the Snack Shack posted throughout the season. - Listing on the RVLL website. $1000 level - All of the above, with the addition of large signage display on the outfield fence throughout the season. $2000 level - All of the above, plus a sign on the Majors field Scoreboard. I cannot sponsor a team, but I would like to help support Ross Valley Little League with a donation of the following amount:
	Little League Day:	My family would like to attend Ross Valley Little League Day at the San Francisco Giants game at AT&T Park on Sunday, May 2nd. Tickets in the special bleacher section with other Ross Valley families are $18 each. Please select how many tickets you would like to purchase: Select 1 2 3 4 5 6 7 8
	T-Shirts:	Ross Valley Little League TShirts are available in both youth and adult sizes for $15 each. Please enter now many TShirts you would like to purchase of each size: Youth Small Youth Medium Youth Large Youth Extra Large Adult Medium Adult Large Adult Extra Large
	Hoodies:	Ross Valley Little League Hoodies (black) are available in both youth and adult sizes for $25 each. Please enter now many Hoodies you would like to purchase of each size: Youth Small Youth Medium Youth Large Youth Extra Large Adult Medium Adult Large Adult Extra Large
	Emergency Contact*:
	Emergency Phone*:
	Health Plan*:
	Plan Number*:
	Doctor*:
	Dr Phone*:
	Medical Issues:
	Previous Injuries:
	Majors and Minors Families Only: (you must read and accept this provision in order to complete registration) I acknowledge that operation of the Snack Shack during games is a requirement of Little League International and requires significant volunteer hours to operate. By checking this box and registering my child for a Majors or Minors team, I agree to work the following number of shifts at the Snack Shack during the regular season and playoffs: Majors (up to 4 shifts per family per season); Minors families (up to 2 shifts per family per season). I understand that my shifts at the Snack Shack may be assigned at times that are inconvenient to me, and that it is my responsibility to work my shift or find another league parent or Board-approved adult volunteer to work the shift. I acknowledge that children under the age of 18 are not acceptable substitutes.
	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.