STREET ADDRESS TOWNSHIP SCHOOL PHONE

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1 HAMPTON ATHLETIC ASSOCIATION 2012 PLAYER REGISTRATION 2012 SLOW PITCH SOFTBALL AGE (as of 12/31/11) Birth Certificate? Checked By TB 8U 10U 12U 15U 18U PLAYER NAME DATE/YEAR OF BIRTH STREET ADDRESS ZIP TOWNSHIP SCHOOL PHONE PARENTS/GUARDIANS NAMES ADDRESS VOLUNTEER TO:(PLEASE FILL IN WHO) MANAGE ASSIST COACH SPECIAL MEDICAL/PHYSICAL INFORMATION ARE YOU PLANNING A VACATION BETWEEN APRIL 15 & JULY 31? YES NO IS YOUR CHILD INVOLVED IN ANOTHER ACTIVITY BETWEEN APRIL 15 & JULY 31? YES NO IF YES, WILL IT TAKE PRECEDENCE OVER SOFTBALL IN THE EVENT OF A CONFLICT? YES NO I, THE PARENT/GUARDIAN OF THE ABOVE NAMED CHILD, HEREBY GIVE MY CONSENT AND APPROVAL FOR MY CHILD S PARTICIPATION IN ANY AND ALL OF THE ACTIVITIES OF THE HAMPTON ATHLETIC ASSOCIATION (THE ASSOCIATION ). IN CASE OF ACCIDENT OR INJURY, I CONSENT TO THE TREATMENT OF MY CHILD BY COMPETENT MEDICAL PERSONNEL. I, THE PARENT/GUARDIAN, RECOGNIZE THAT THE ACTIVITIES CONTEMPLATED BY THIS REGISTRATION INVOLVE SIGNIFICANT PHYSICAL EXERTION AND THE USE OF BASEBALLS/SOFTBALLS AND BATS NECESSARY TO PLAY THE GAME, AND THAT THERE IS A RISK OF PHYSICAL INJURY ASSOCIATED WITH THE GAME. I AGREE TO HOLD HARMLESS THE ASSOCIATION AND ITS ORGANIZERS, SPONSORS, VOLUNTEERS, OFFICERS, DIRECTORS, PARTICIPANTS, AND PERSONS TRANSPORTING MY CHILD TO AND FROM ACTIVITIES FROM AND AGAINST ANY CLAIM THAT MAY ARISE OUT OF MY CHILD S PARTICIPATION IN THE ASSOCIATION S ACTIVITIES, INCLUDING, BUT NOT LIMITED TO, ANY INJURY TO MY CHILD. PARENT/GUARDIAN SIGNATURE DATE HAMPTON ATHLETIC ASSOCIATION 2012 PLAYER REGISTRATION 2012 SLOW PITCH SOFTBALL AGE (as of 12/31/11) Birth Certificate? Checked By TB 8U 10U 12U 15U 18U PLAYER NAME DATE/YEAR OF BIRTH STREET ADDRESS ZIP TOWNSHIP SCHOOL PHONE PARENTS/GUARDIANS NAMES ADDRESS VOLUNTEER TO:(PLEASE FILL IN WHO) MANAGE ASSIST COACH SPECIAL MEDICAL/PHYSICAL INFORMATION ARE YOU PLANNING A VACATION BETWEEN APRIL 15 & JULY 31? YES NO IS YOUR CHILD INVOLVED IN ANOTHER ACTIVITY BETWEEN APRIL 15 & JULY 31? YES NO IF YES, WILL IT TAKE PRECEDENCE OVER SOFTBALL IN THE EVENT OF A CONFLICT? YES NO I, THE PARENT/GUARDIAN OF THE ABOVE NAMED CHILD, HEREBY GIVE MY CONSENT AND APPROVAL FOR MY CHILD S PARTICIPATION IN ANY AND ALL OF THE ACTIVITIES OF THE HAMPTON ATHLETIC ASSOCIATION (THE ASSOCIATION ). IN CASE OF ACCIDENT OR INJURY, I CONSENT TO THE TREATMENT OF MY CHILD BY COMPETENT MEDICAL PERSONNEL. I, THE PARENT/GUARDIAN, RECOGNIZE THAT THE ACTIVITIES CONTEMPLATED BY THIS REGISTRATION INVOLVE SIGNIFICANT PHYSICAL EXERTION AND THE USE OF BASEBALLS/SOFTBALLS AND BATS NECESSARY TO PLAY THE GAME, AND THAT THERE IS A RISK OF PHYSICAL INJURY ASSOCIATED WITH THE GAME. I AGREE TO HOLD HARMLESS THE ASSOCIATION AND ITS ORGANIZERS, SPONSORS, VOLUNTEERS, OFFICERS, DIRECTORS, PARTICIPANTS, AND PERSONS TRANSPORTING MY CHILD TO AND FROM ACTIVITIES FROM AND AGAINST ANY CLAIM THAT MAY ARISE OUT OF MY CHILD S PARTICIPATION IN THE ASSOCIATION S ACTIVITIES, INCLUDING, BUT NOT LIMITED TO, ANY INJURY TO MY CHILD. PARENT/GUARDIAN SIGNATURE DATE

2 2012 Little League Age Chart For Softball Divisions Only Match month (top line) and box with year of birth. League age indicated at right. JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC AGE Note: This age chart is for softball divisions only, and only for 2012.

3 Hampton Athletic Association Dear Parents, This year we are asking each family to help us defer the cost of our baseball & softball program by selling the Olde Country Lucky Lotto Raffle tickets. We will be using the proceeds of this ticket sale to help with the ever increasing costs of field maintenance, new equipment, uniforms, insurance & more. Your help is greatly needed & appreciated. Instructions for selling the tickets are listed below. Sincerely, Hampton Athletic Association Instructions for your Lucky Lotto Ticket Sale * Each book contains 40 spots to rub off & 50 tickets. The buyer of the ticket will rub a spot to determine the cost of their donation. They will pay that amount, fill out the ticket stub & receive their ticket. Since you have already prepaid for your tickets keep the money you receive from the sale of these tickets ($115.00). * The winning tickets will be drawn at our Championship Day ceremonies which this year is Saturday June 23, * Your ticket stubs are due back to your team manager no later than April 7th (the 1st week of practice). As a special thank you for helping with this year's fundraiser we have put 10 extra tickets in each book of tickets. Those 10 extra tickets are yours - THEY ARE FREE as a thank you for helping with this year's fundraiser. That gives you 10 FREE CHANCES at winning one of four prizes that total over $2, in value!!!! Best wishes for a safe & enjoyable season. For questions call Eric Marsonek at (412)

4 Age Group 2012 Season Option 1 Registration Fee Raffle Fee Total Initial Fee Potential Return Final Fee T-Ball Baseball (6U) $ $ $ $ $ Minor Baseball (8U) $ $ $ $ $ American Baseball (10U) $ $ $ $ $ Bronco Baseball (12U) $ $ $ $ $ Pony Baseball (14U) $ $ $ $ $ Colt Baseball (16U) $ $ $ $ $ Palomino Baseball (18U) $ $ $ $ $ T-Ball Softball (6U) $ $ $ $ $ U Softball $ $ $ $ $ U Fast Pitch Softball $ $ $ $ $ U Slow Pitch Softball $ $ $ $ $ U Fast Pitch Softball $ $ $ $ $ U Slow Pitch Softball $ $ $ $ $ U Fast Pitch Softball $ $ $ $ $ U Slow Pitch Softball $ $ $ $ $ U Fast Pitch Softball $ $ $ $ $ U Slow Pitch Softball $ $ $ $ $ Families are capped at 2 books per family 1 player = 1 book 2 players = 2 books 3 players = 2 books 4 players = 2 books

5 HAMPTON ATHLETIC ASSOCIATION P.0. BOX 45 ALLISON PARK, PA FAMILY REGISTRATION RECORD BOYS BASEBALL AGES 4 18 BY MAY 1, 2012 GIRLS SOFTBALL AGES 4 18 BY JANUARY 1, 2012 FAMILY NAME PHONE NUMBER ADDRESS BASEBALL REGISTRATION AGES LEAGUE FEE # PLAYERS AMOUNT 4 6 Shetland $ Pinto $ Mustang $ Pony $ Bronco $ Colt $ Palomino $50 SOFTBALL REGISTRATION AGES LEAGUE FEE # PLAYERS AMOUNT 4 6 Shetland $ U $ U $ U $ U $ U $50 OLD COUNTRY LUCKY LOTTO RAFFLE BOOKS (maximum of 2 books per family) FEE # BOOKS AMOUNT $115 FAMILY REGISTRATION TOTAL

6 BASEBALL HAMPTON ATHLETIC ASSOCIATION 2012 Uniform Size Worksheet SOFTBALL PLAYER S NAME: PARENT S/GUARDIAN S PHONE NUMBER: LEAGUE: SHIRT SIZE: YOUTH S M L XL PANTS: YOUTH XS S M L XL SOCKS: S M L HATS: YOUTH ADULT (OFFICIAL USE ONLY) BASEBALL HAMPTON ATHLETIC ASSOCIATION 2012 Uniform Size Worksheet SOFTBALL PLAYER S NAME: PARENT S/GUARDIAN S PHONE NUMBER: LEAGUE: SHIRT SIZE: YOUTH S M L XL PANTS: YOUTH XS S M L XL SOCKS: S M L HATS: YOUTH ADULT (OFFICIAL USE ONLY)

7 HAMPTON ATHLETIC ASSOCIATION 2012 APPLICATION FOR BASEBALL/SOFTBALL VOLUNTEER MANAGER/COACH NAME ADDRESS Home Phone Work Phone Cell Phone Date of Birth Hampton Resident? How many years? Occupation Employer Please provide a summary of any coaching experience: YES NO Have you ever been refused participation in any other youth organization? Have you ever been convicted of any felony offense? Have you ever been arrested for any crime involving a child? Are you currently on probation or parole for any criminal offense? (If yes, provide name and contact information for controlling agency below.) If you answered YES to any of the above, please explain fully: I acknowledge that I understand this application and that all information provided is true and correct. In addition, by signing below, I authorize the Hampton Athletic Association (HAA) to perform further background checks on me if deemed necessary by the HAA. I understand that these checks may include local, state and national sex offender and child abuse registries, as well as any local, state, and national criminal history records. Further, I will provide any additional personal information necessary to complete said background check. Please note that as a manager you are expected to attend approximately 90% of your games. If you are unable to do so, the Executive Officers have the ability to take action where deemed necessary. Signature Date HAA review IF RETURNING BY MAIL, SEND TO: Bill Jamison 3343 Oaknoll Road Gibsonia, PA Phone