Heartbreakers Softball Registration
Complete this form to register for Heartbreakers Softball open practices and/or tryouts.
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Athlete Name *
Athlete Email Address (if applicable)
Athlete Phone Number (if 16+ years old)
Address (include city, state, zip) *
Phone Number *
School *
Birthday *
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/
DD
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Age As of August 31st of This Current Year *
Age group/team you are trying out for: *
Required
Current Travel Team (if applicable)
Primary Positions Played *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
Does the athlete have allergies, chronic illness, or medical conditions? If yes, please describe. *
Parent/Guardian Signature (type full name to accept waiver)

WAIVER: 
I, as the parent or guardian of the player do hereby give my approval for their participation in any and all HEARTBREAKER SOFTBALL activities. I hereby grant my permission to managing personnel or other league representatives to authorize and obtain medical care, at my expense, from any licensed physician, hospital or medical clinic should the player become ill or injured while participating in activities away from home, or where neither parent or legal guardian is available to grant authorization for emergency treatment.


I assume all risks and hazards incidental to my child’s participation, including transportation to and from the activities; and do hereby waive, release, absolve, indemnify and agree to hold harmless the HEARTBREAKER organization, the organizers, sponsors, supervisors, participants and persons transporting the player to and from the activities, for any and all claims arising out of an injury to the player.

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