Mesquite Baseball Inc Player Registration

PO Box 871205
Mesquite, TX 75150
www.MesquiteBaseball.org

Player Information

First Name *

Middle Initial

Last Name *

Birth Date +

Residence Street Address *

City *

ZIP Code *

Please upload a clear copy of the players Birth Certificate *

Please upload a recent picture of your child. (Recent school picture works best) *

Parental Authorization

I, the parent or gaurdian of the above-named candidate for a position on a baseball team, hereby give approval to participate in any and all league activities during the current season. I assume all risks and hazards incidental to such participation including transportation to and from the activities, and do hereby waive, release, absolve indemnify, and agree to hold harmless Mesquite Baseball Inc, the organizers, sponsors, supervisors, participants and persons transporting the player to and from activites, for any claim arising out of an injury to the player, except to the extent, and in the amount covered by accident and/or liability insurance held by the local league.

I also grant permission to managing personnel or other league representatives to authorize and obtain medical care from any licensed physician, hospital or medical clinic should the player becom ill or injured while participating in league activites away from home, or at other times when neither parent is available to grant authorization for emergency treatment.

I will attach a certified birth certificate of the above-named candidate upon request by league officials. If I am unable to upload a certificate or if the image is not readable, I will furnish a certified birth certificate on request. MBI officials may also request a copy at any point in the season.

I understand that team team manager (not the league) is solely responsible for all financial matters pertaining to his or her team.

Has this player been a part of Mesquite Baseball team in the last 12 months? *

Yes

Prior MBI Team Information (Age level & team name)

Household / Adult Primary Contact

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone

Alternate Phone

Email Address *

I hereby affirm that the information provided in this form is true, correct, and complete to the best of my knowledge. I understand that any false statements, omissions, or other misrepresentations made by me on this form may result in penalties or legal actions under the laws of the State of Texas.

Please Sign below: *

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