VSRS Registration - Spring 2025

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This form will not be completed until you click the SUBMIT button after the payment explanations.

Player Information

Player First Name *

Player Last Name *

Street address *

City *

State *

Zipcode *

Player email or phone number (if applicable)

Date of Birth *

YYYY

Grade *

School *

How many years have you played softball? *

Does your daughter have any pitching experience?

Yes

Clear selection

Does your daughter have any catching experience?

Yes

Clear selection

Parent / Guardian Information

First Name (First Parent) *

Last Name (First Parent) *

Email (First Parent) *

Phone Number (First Parent) *

Best number to reach you

First Name (Second Parent)

Last Name (Second Parent)

Email (Second Parent)

Phone Number (Second Parent)

Best number to reach you

I am interested in

Head Coach

Assistant Coach

Volunteering

Please check the following *

I, the undersigned, in consideration for the participation of my child in VSRS, do hereby waive and release any rights and claims that I might have against VSRS (VA Stingrays) and it’s agents, for any injuries, losses sustained while participating in the VSRS practices, games or tournament play, and agree to hold VA Stingrays harmless and to indemnify it from any damages suffered during said participation.

Required

Parent Initials *

Please initial to indicate your completion of this form and agreement to the above.

After submitting this form, send a check.

8u/10u players $100.00

12u/18u players $160.00

Please make checks payable to: VIRGINIA STINGRAYS

TOM DICKSON, VSRS
4005 DAKOTA COURT
ALEXANDRIA, VA 22312

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