2004 SOFTBALL AND BASEBALL REGISTRATION FORM
Huntingdon Valley Activities Association
P.O. Box 155
Huntingdon Valley, PA 19006
(215) 947-9823 ext 3

HVAA Use Only
Cash/Money Order Amount ______
Ck. # _______ Ck. Date ______
Ck. Amount ______ Late Fee______
1st 2nd 3rd 4th __th Child
Registered

PLEASE FILL OUT COMPLETELY AND PRINT NEATLY

Comments: ____________________________________________________________________________________
_____________________________________________________________________________________________

q      Interested in Travel Only. Not interested in playing in the In House League.
q      Interested in Travel, but will play In House if I'm not selected For Travel.
q      Please mark if this is the FIRST time you are registering your child in an HVAA activity.

q Please mark if the address and/or phone number listed below has changed since the last time you
registered your child in an HVAA activity.

Child’s Name: __________________________    Sex: M____ F____      Height: ____ FT. ____IN.
Address:          __________________________    Phone #_________________________________
                          __________________________    Date Of Birth: ___/___/____   Age As of 9/1/2004: _____
                          ___________________________   Grade Child Will Be Entering In 2004/2005 School-year:_____
Please list two contacts HVAA can use to inform you of schedules, rosters and other pertinent details applicable to your child.
Contact 1: ______________________    Phone #: __________________ Relationship to child: _______________
     Work Phone #:_______________________   Cell Phone #:____________________
Contact 2: ______________________    Phone #: __________________ Relationship to child: _______________
      Work      Work Phone #:_______________    Cell Phone #:___________________
A family member has ___ has not ____ attended a mandatory HVAA Parent Education Class

Registration Fees and Dates (the postmark will determine if a Registration Form is considered late)
Deadline to register is March 1, 2004
     Fee before February 15^th (no late fee assessed): 1^st Child - $75, 2^nd Child - $55, Additional Children - $40 each
     Fee on or after February 15^th ($30 late fee per child assessed): 1^st Child - $105, 2^nd Child - $85, Additional Children - $70 each
     There will be an additional fee of $25 for travel sports participants, collected if and when players are selected for the team.
Parental Waiver and Consent Form: As the parent or legal guardian of the above child, I hereby request and give my full consent and approval for my child to participate as a team member in the sport designated above. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist. I understand that risks of injury are inherent in the practice and play of this sport, as well as in traveling and other related activities incidental to my child’s participation, and I am willing to assume these risks on behalf of my child, even if arising from the negligence or gross negligence of the releasees or others, and assume full responsibility for my child’s participation. I hereby certify my child is fully capable of participating in the designated sport and my child is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities. In addition to giving my full consent for my child’s participation, I do hereby waive, release and hold harmless the organization named above, its officers, coaches, sponsors, supervisors and representatives for any injury that may be suffered by my child in the normal course of participation in the designated sport and the activities incidental thereto, whether the result of negligence, gross negligence or any other cause. I have read this registration/consent form. I give full consent for my child’s participation.
Child Participation: Under HVAA rules, any child may be prohibited from participating in future programs if he/she does not attend at least 75% of all games and practices
.Refund Policy: If you wish to withdraw your child from the program and request a return of your registration fee, you must submit your request in writing by regular mail at P.O. Box 155, Huntingdon Valley, PA 19006, postmarked on or before March 15^th, 2004. Requests after that date will not be honored.
Game Scheduling: Due to limited availability of facilities and the uncertainty as to the number and/or ages of children registering for the sport, game and practice schedules cannot be determined until after the drafting of teams occurs.

Parent/Guardian Signature: _____________________________________ Date: _______________(MUST BE SIGNED & DATED!)

q Please mark if the E-mail address listed below has changed since the last time you registered your child in an HVAA activity.

Parent/Guardian E-mail address: ______________________________________________________ (PLEASE PRINT NEATLY)
By signing this registration form, children, parents and coaches agree to comply with HVAA’s code of conduct. The Board of Directors reserves the right to refuse to register any child for any reason and to remove any child from any activity at any time.