SYBA Registration Form RM_StatsPlayer Last Name *Player First Name *Player Birthdate *Player Grade *Parent/Guardian Last Name *Parent/Guardian First Name *Parent/Guardian Phone *Parent/Guardian Email *Secondary ContactSecondary Contact PhoneEmergency ContactEmergency Contact PhonePlayer is *BoyGirlJersey Size *Youth X-SmallYouth SmallYouth MediumYouth LargeYouth X-LargeYouth 2XLAdult X-SmallAdult SmallAdult MediumAdult LargeAdult X-LargeAdult 2XLPreferred coach/teamAre you interested in being a coach/asst. coach? Yes No Are you interested in serving on the board? Yes No We/I hereby request that you accept the application enrollment of my child named above in the SYBA program. In consideration of your acceptance of the application, we/I hereby release the Association Board from all claims regarding injuries that may be sustained by our/my child of any such injury. We/I understand that any participant who does not abide by the league rules may be dismissed with no refund. In the event of illness/injury, we/I hereby give our/my consent for medical treatment and permission to the attending physician to hospitalize, secure proper treatment, and order injection, anesthesia, or surgery. We/I will be responsible for any medical and/or any other charges regarding my child’s participation in the SYBA. We/I certify that my/our child is covered by medical insurance and certify that my/our child is physically capable of participating in the SYBA. I fully understand that I am responsible for all equipment issued to my child and CAN BE HELD MONETARILY RESPONSIBLE FOR ITS REPLACEMENT.Parent/Guardian Full Name *By entering my name here, I acknowledge and consent that this electronic form of signature holds the same legal validity and impact as a physical signature.Date *SYBA Player Registration Fee *Select a payment method * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
