2021 Southern Chaos Fast Pitch Tryout Registration Form

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Southern Chaos Fast Pitch is a Nash/Edgecombe/Wilson County based Girls Fast Pitch Softball program and are planning to field 10u, 12u, 14u, and High School Teams in the spring of 2022. We also have a membership partnership with new indoor facility called Big League Batting Center in Nashville where a membership is included with team dues. We normally schedule 8 tournaments in spring/summer and 5-6 tournaments in fall. We practice at local fields in the Rocky Mount area and indoors at Big League Batting Center. We are a family oriented organization that enjoys drama free softball and works hard to help our players improve and for out teams to successful on the field.

If interested in trying out for one our teams please complete this form, email southernchaosfastpitchnc@gmail.com
or
call/text 919-394-6523

Child's Full Name *

Birthdate *

YYYY

Age as of Dec 31, 2021 *

Address *

Parent/Guardian Name *

Parent/Guardian Cell# *

Parent/Guardian Email Address *

Primary Position *

Secondary Position *

Emergency Contact Name *

Emergency Contact Phone Number *

Doctors Name *

Doctors Phone Number *

Jersey Number

Shirt Size *

Pant size *

I, the undersigned, understand the participation in fast pitch softball may result in injuries. I know that protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify, the Southern Chaos Fast Pitch Softball Team, the organizers, sponsors, supervisors, participants, landlords, property owners, and persons transporting my child to and from activities or any claim arising out of any injury to my child whether result of negligence or any other cause. I also do hereby authorize that certified medical centers/hospitals are given the authority to render necessary medical services to my child, which result, directly or indirectly, from her participation in trips, programs, events, activities sponsored by Southern Chaos Fast Pitch Softball Team. I also hereby agree to be responsible for such charges that are made by such medical center/hospital, doctor, etc. in providing such medical services as are referred above. Please type name below signifying you understand all that is stated above. *

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