Name:

T-shirt size:
Uniform number:
Position:
Address:

Phone:
Parents Name:

In case of emergency notify:
Person:                                 Phone:

Hospital Preference:

Waiver of Liability(must be signed by parent or guardian to be valid registration)
Central Illinois Wood Bat Baseball League, Springfield Lutheran High School is not responsible for any injuries/death/accidents/ COVID-19 virus that may happen before,during and after any games.I agree to waive and relinquish all claims I may have as a result of participating in Central Illinois baseball League against the League, and its officers,umpires, Springfield Lutheran High School. I have read and fully understand the above waiver and release of all claims. In the event of injury to my child, and I cannot be reached immediately, I hereby authorize the manager or coach in charge to provide first aid or treatment as deemed necessary which might include hospital treatment or admission until such time as I can be contacted.

Parent or Guardian signature:

Adult player signature over 18 yrs old: 

Please mail information and make check payable to:
Troy Vilayhong

2508 Shadow Chaser Dr

Springfield, IL 62711