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GAUTENG PROVINCE BASEBALL COUNCIL

REGIONS *

Club *

School (Juniors)*

Full Name *

Email *

Cellphone number *

Identity Number *

Race *

Male / Female *

Male

Female

Player Age at 31/12/2021 *

League / Age group / Admin role / Member *

PEE-WEE U8 (BIRTH YEAR 2013+)

U10 (BIRTH YEAR 2011-2012-2013)

U12 (BIRTH YEAR 2009-2010)

U15 (BIRTH YEAR 2006-2007-2008)

U18 (BIRTH YEAR 2005-2004)

Mens

Woman

Masters

Coach Staff

Scorer Staff

Umpire

Member

Number of years playing baseball: *

0-2yr

2-5yr

5-10yr

longer than 10yr

Represented South Africa: Y / N *

Yes

If yes, state years:

Represented District/ Provincial : Y / N * *

Yes

If yes, state years:

Position/s: *

Pitcher

Catcher

Infield

Outfield

Admin/Coach/Umpire/Scorer

Other:

Bats: L / R *

Left handed

Right handed

Not applicable

Throws: L / R *

Left handed

Right handed

Not applicable

If person with disability, please specify

Please find covid-19 form on GPBC website

http://www.gpbc.co.za/2020/10/06/gpbc-covid-19-transmission-indemnity-form/

COVID-19 TRANSMISSION INDEMNITY FORM. I/WE DO HEREBY DECLARE AND CERTIFY THAT I/WE HAVE READ THIS DOCUMENT AND I/WE FULLY UNDERSTAND THE CONTENT THEREOF. I AM/WE ARE AWARE THAT THIS IS AN INDEMNITY AND RELEASE OF LIABILITY AND I/WE SIGN IT OF MY OWN FREE WILL *

Yes

Required

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