LOUISIANA BLAST BASEBALL
REGISTRATION FORM
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Blast Registration
PLAYER'S NAME & ADDRESS
DATE OF BIRTH & GRADUATION YEAR
MM
/
DD
/
YYYY
SCHOOL GRADE & PLAYER'S AGE AS OF MAY 1 OF NEXT SEASON
PRIOR TEAM NAME & POSITIONS PLAYED
HITS (RIGHT OR LEFT- HANDED)
FIELDS (RIGHT OR LEFT-HANDED)
TOP 5 JERSEY NUMBER CHOICES (FOR TEAMS)
MOTHER'S NAME & EMAIL ADDRESS
MOTHER'S PHONE
FATHER'S NAME & EMAIL ADDRESS
FATHER'S PHONE
PERSON(S) TO CONTACT IN EVENT OF EMERGENCY
PERSON(S) TO CONTACT IN EVENT OF EMERGENCY
RELEASE - I/We, the undersigned, hereby certify that I/We am/are the parent(s) or legal guardians of the participant listed below.   I/We hereby give permission for the staff of Louisiana Blast Baseball to seek, during the baseball practices, medical attention for the player and for the medical attention to be given and for the player to receive medical attention in the event of accident, injury, or illness.  I/We, the undersigned, for ourselves, our heirs, executors and administrators, waive, release and forever discharge the Louisiana Blast Baseball staff, officers, agents, employees, representatives, successors and assign of and from all rights and claims for damages, injury, or loss to person or property, which may be sustained during participation in baseball activities or while at the facility whether or not damages, injury or loss is due to negligence.  I understand that if my child has been exposed to someone who has tested positive for COVID-19, HE SHOULD NOT PARTICIPATE IN SUCH ACTIVITIES.  I ALSO RELEASE ANY AND ALL LIABILITY, AND AGREE TO HOLD HARMLESS, ALL INDIVIDUALS ASSOCIATED WITH, AS WELL AS THE LOUISIANA BLAST BASEBALL ORGANIZATION IF MY CHILD OR MYSELF BEGINS TO SHOW SYMPTOMS OF COVID-19 AFTER PARTICIPATING IN BASEBALL ACTIVITIES OR WHILE AT THE FACILITY.  (Parent Signature Required) *Acknowledge by typing YES or NO below, along with parent's name.
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