SPORTS CONCERN SOFTBALL TEAM ROSTER

TEAM NAME:_______________________________________

Is your Team ASA Registered ( ) Yes ( ) No If not, Please Remit $10.00 for Registration
ASA Commissioner's Name: _______________________________ Phone: ________________________
( ) Firecracker - Men's "D" ( ) Summer Swing 'n Fling - COED

( ) Men's Over 40*

( ) Fallbuster - Wooden Bat ( ) Ladies Days - Women's "C"

( ) Competitive

Amount of Check $__________

( ) Recreational

NAME (Please Print) SIGNATURE*
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In Lieu of each players signature, the managers signature will be binding for the names listed as players. The softball team identified on this page, its sponsor(s) and players hereby agree to, and shall hold SPORTS CONCERN, its members, players and agents harmless from any liability for damages or claims for damages for personal injury, including death, as well as from claims for property damage which may arise from its attendance at the SOFTBALL TOURNAMENT specified.

Managers Name_________________________________________________________________________
Managers Signature______________________________________________________________________
Address_______________________________________________________________________________
City_____________________________________________________  State__________  Zip___________
Home Phone__________________ Work Phone__________________ Cell Phone___________________
email address___________________________________________________________________________