Canandaigua Jr.

Baseball/YMCA 2010 Fall Ball Registration

Registration Form for ROOKIE only

Register in Person at the Canandaigua YMCA Wednesday August 25th from 6PM-8PM

Or

FORWARD COMPLETED FORM AND $20 PAYABLE TO

“CANANDAIGUA JUNIOR BASEBALL” TO:

Via Mail Postmarked by August 31, 2010 to:

Jason Outhouse 3327 Dandelion Tr Canandaigua, NY 14424

***IN PERSON REGISTRATIONS GET FIRST PRIORITY DUE TO ROSTER LIMITS***

Child’s Name: Cayden Masterson Age as of 5/1/10: 7

Fall 2010 Grade : 2nd Date of Birth: 5/3/03

Spring 2010 League and Team:_______________ Phone#:_________________

Shirt Size: Youth Medium Youth Large Adult Medium Adult Large

Father’s Name: Chris Masterson Phone#: 404-839-1014

Mother’s Name: Shannon Masterson Phone#: 404-771-0995

Parent E-Mail Address: shannon.masterson@gmail.com

Comments/Volunteer Info:_________________________________________________________

Medical Release
I understand that the sport of baseball is a physical sport, and my child can be injured by playing. I also
understand that this injury can be of minor or major variety. With this in my mind, I give my permission for my
child to participate in the program. If my child needs medical attention, it is my wish that I am contacted before
any medical procedures are done on the child, unless immediate treatment is necessary to save the life of my
child, or prevent permanent injury.

Signature of Parent or Guardian:___________________________________________Date:___________

$20.00 received by______________________ Date:____________________

Cash:______________ Check#:__________________