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SPONSORSHIP Opportunities

  <<< O >>>

If you prefer to submit a paper application
click here for a downloadable Baseball Registration Form in PDF format.
If you do not have a copy of the PDF Reader, see the bottom of this page.


Legion & Teener Baseball Registration Form
Player's First Name  
Player's Last Name  
Player's Birth Date  
Street Address  
City  
ZIP Code  
Home Telephone  
Player's Cell Phone Phone  
Email Address  
Father First Name  
Father Last Name  
Father Work Phone  
Father Cell Phone    
Father Email  
Mother First Name  
Mother Last Name  
Mother Work Phone  
Mother Cell Phone    
Mother Email  
Insurance Provider  
Insurance Policy #  
Pant Size
Please select only one
YOUTH Sizes
 
Medium
Large
X-Large
ADULT Sizes
Small
Medium
Large
X-Large
Shirt Size
Please select only one
(Adult Size)
Small
Medium
Large
X-Large
 X-X-Large
Previous Team(s) Played On  
Position(s) Played  
   

By my electronic signature and submitting this form, I, the undersigned parent/guardian of the above named athlete, do hereby make application and give my approval for his/her participation in any and all of the activities required during the current season of the Paxton Athletic Associationís (PAA) Legion and Teener baseball program. I assume all the risks and hazards incidental to the conduct of the activity, as well as transportation to and from such activities. I do hereby release, absolve, indemnify and hold harmless, the PAA, the organizers, sponsors, coaches, supervisors and/or any other persons placed in a supervisory capacity over such activities, and do hereby waive any claims which may arise because of the agreement and/or these activities.

I do hereby attest that I do carry the above insurance and do fully agree that any injuries incurred by the athlete during these activities will be charged to this insurance. I understand that the PAA does carry an excess insurance policy which will, within the limits of such policy, pay any medical, dental and/or hospital expenses not paid by my insurance, providing such injury is reported to the PAA within forty-eight (48) hours of such injury. I do understand that each athlete may be required to undergo a physical examination prior to entry into some activities. If such physical is required, the PAA will furnish the necessary forms, but the cost of such examinations will be borne by me, the parent/guardian.

Furthermore, I do hereby agree, by my signature below, to be responsible for any equipment signed out by the athlete. I do agree to return to the PAA, at the request of the head coach or upon the resignation or removal of the athlete, all equipment signed out. This equipment will be clean and in at least the same condition as when issued, minus normal wear and tear. I further agree to reimburse the PAA for any equipment lost, destroyed or damaged, and to reimburse the same for any cleaning expenses required. I understand that there will be additional equipment needed by the athlete which is not furnished by the PAA. Baseball gloves, shoes, athletic supporters, mouthpieces, etc., are just some of the items which are required and will be the responsibility of the parent/guardian.

I understand that the PAA makes no promises as to the playing time my athlete may experience during the season. Playing time will be at the discretion of the head coach, and will be determined by the athleteís own abilities, attitude, effort and his participation and in practice sessions, games, etc. To all of the above, I do formally agree and give my full consent and approval to this athlete to participate in the PAA Legion and Teener baseball program.

I hereby grant Paxton Athletic Association to use the photo and or other digital reproduction of his/her physical likeness for publication processes, whether electronic, print, digital or electronic publishing via the Internet.

   
Type of payment to be submitted
Secure payment form is at bottom of this page,
 and must be submitted separately
after completing this Registration Form.
 

  Please see info below regarding the choices between the FUNDRAISER and BUYOUT options

   
Parent or Guardian Electronically Signing Form  
Today's Date   mm-dd-yy

 

Your registration is not complete until your payment has been received.
Please come back to this page to complete your payment (below).

    


 

Please submit your Registration Payment here.

   

PayPal payment processing accepts
Credit or Debit Cards and PayPal accounts

Solution Graphics
   

Please note that in addition to the registration fee, participants will be asked to EITHER
[A] participate in a Fundraiser OR [B] pay a Buyout Fee.

Players who choose the FUNDRAISER option will be asked to sell at least 10 tickets for a Lucky Number Raffle at $10 each. (Family Registrations will be asked to sell 15 tickets.)
The Raffle is conducted under
Small Games of Chance Permit #4 for Dauphin County.

Those who choose the Fundraiser option must come to one of the Registration sessions in order to obtain the tickets.
Registration will be held January 26
from 9 to Noon at the Lower Paxton Friendship Center,
5000 Commons Dr, Harrisburg, PA, 17112.
Players who choose the BUY-OUT option can buy-out of the Fundraiser by paying $80.  Families can buy-out of the Fundraiser by paying $110.

Those who choose the Buyout option and pay online are not required to attend a Registration session.
However, they are welcome to participate if they choose, or have questions.
   

To complete your registration with an online secure payment using a
Credit or Debit Card, please
[1] choose Individual or Family,
[2] whether you choose the Buyout option, and
[3] click the Paxton Payment button.

Choose Individual or Family + Buyout
Enter Comments Here
   

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