Player & Parent Agreement - Pope Athletics: Baseball

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Spring/Summer 2024

Student Athletes's Last Name *

Student Athlete's First Name *

Birthdate (MM/DD/Year) *

YYYY

Age (As of May 1st, 2024) *

Grade (As of the start of 2023-2024 School Year) *

Name of School he/she attends? *

Street Address *

City, State, Zip Code *

Preferred Number (List 3 in priority order)

Jersey Size *

YXS

YXL

AdultSmall

AMedium

ALarge

AXLarge

Pant Size *

YXS

YXL

Adult Small

AMedium

ALarge

AXLarge

Parent/Guardian's Last Name/s *

Parent/Guardian's First Name *

Parent/Guardian's Cell Phone Number/s *

Parent/Guardians's Email/s *

Emergency Med Info - Allergies *

Yes

Emergency Med Info - Medications *

Yes

Emergency Med Info - Medical Conditions *

Yes

My child needs an accommodation to participate because of a disability? *

Yes

If answered yes to Emergency Med Info above, please list allergies, medications, medical conditions and/or accommodations needed here:

Doctor's Name *

Doctor's Phone Contact *

Hospital/Clinic + Address *

Do you currently have Health Insurance? *

Yes

If yes, please list Health Insurance Name + Insurance ID or Group Number

Emergency Contact (Full Name) *

Emergency Contact (Phone) *

Emergency Contact (Relationship) *

Liability/Consent & Assumption of Risk Waiver

Liability /Consent & Assumption of Risk Waiver *

Accepted by Parent/Guardian

Required

Player/Parent Agreement (Pt 1) *