Team Roster

The Batter’s Box Phone: 636-916-4547

3685 New Town Blvd. Fax: 636-916-4549

St. Charles, MO 63301 jelder@stlbattersbox.com

I the undersigned (if applicant/participant is 18 years of age or older) or parent/guardian of the below listed minor applicant/participant acknowledge and fully understand that each applicant/participant will be engaging in activities that involve risk of serious injury, including permanent disability or death, and severe social and economic losses which might result not only from their own actions, inactions or negligence, but action, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used and further, that there may be other unknown risks not reasonably foreseeable at this time, assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, hereby release, discharge, covenants to indemnify and not to sue The Batter’s Box, its affiliated organizations and sponsors, their coaches, managers, employees and associated personnel, officers, directors agents, including the owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as ‘releasees’, from any and all liability to each of the undersigned, his/her heirs or next of kin for any and all against any claim by or on behalf of the applicant as a result of the applicant’s participation in the Programs. The applicant/participant has received a physical examination by a physician and has been found physically capable of participating in the Programs. I, also agree to save and hold harmless and indemnify each and all parties herein referred to above as releasee from all liability, loss, cost, claim or damage whatsoever, including dearth or damage to property, which may be imposed upon said releasee because of any defect in or lack of such capacity to so act or caused or alleged to be caused in whole or in part by the negligence of the release. I have read the above waiver/release and understand that (I)we have given up substantial rights by signing this release and sign below voluntarily.

Team Roster

Team Name:________________________________ 2010 Tournament:________________________________ Today’s Date:________

Team Age:_______________________________________________ Classification of Team (circle one): National American Minor

Team Manager:____________________________________________ Business Manager:_______________________________________

Street Address:_____________________________________________ Street Address:_________________________________________

City, State & Zip:___________________________________________ City, State & Zip:_______________________________________

E-mail:___________________________________________________ E-mail:________________________________________________

Mobile Phone Number:______________________________________ Mobile Phone Number:____________________________________

Home Phone Number:_______________________________________ Home Phone Number:_____________________________________

Player’s

First Name

Player’s

Last Name

Date of

Birth

Address

Street, City, State, Zip

Parent/Legal Guardian Signature

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