Registration 2011
Register
Use this form to register your child for the 2011 TJBS season by 4/4/2011.  
Register now and save money.  Rates may go up as the season draws nearer.  
Registration fees are $50 for one child, $75 for two children and $10 for each
additional child.  See payment information at bottom of this form.
Player's name
Gender (M or F)
Date of Birth (MMDDYY):
Age as of Jan. 1, 2011:
Select desired league:

T-ball
Boys & Girls (4, 5 & 6)

Pee-Wee (7, 8 & 9)
(Coach Pitch)
Pee-Wee Girls (PWG)
Pee-Wee Boys (PWB)

Farm League (9 & 10)
(Kid Pitch)
Farm League Girls (FLG)
Farm League Boys (FLB)
Jr. Girls (11 & 12)
Little League Boys (11 & 12)

14U Girls Fast Pitch ( 13 & 14)
Pony League Boys (13-15)

16U Girls Fast Pitch (15 & 16)
Mother's Name:
Mother's Phone No. 1:
Mother's Address:
Father's Name:
Father's Phone No. 1:
Father's Address:
Relative / Guardian:
Relative / Guardian Phone No:
E-mail address:
E-mail address:
MEDICAL INFORMATION & AUTHORIZATION:
PURPOSE- TO ENABLE PARENTS AND/OR GUARDIANS TO
AUTHORIZE THE PROVISION OF EMERGENCY TREATMENT
FOR CHILD WHO MIGHT BECOME ILL  OR INJURED WHILE
UNDER TRIAD JR. BASEBALL AND SOFTBALL ASSOCIATION  
AUTHORITY, WHEN PARENT AND/OR GUARDIAN CANNOT BE
REACHED.
Doctor's Name & Phone:
Dentist's Name & Phone:
Hospital's Name & Phone:
Please list all medial conditions and/or allergies:
Mark all fields which apply:
I am willing to coach or help coach (C or HC):
I am willing to help with Tournaments (Y/N):
Write in field all that apply:  I would like to help with (Fund Raising)
(4th of July) (Maintenance)  (Field Work) (Team Sponsoring) (Park
Clean-up):
By submitting this registration form to TJBS, you (the Mother,
Father or Legal Guardian):
1) hereby authorize the emergency treatment for your child if he or
she might become ill or injured while under Triad Jr. Baseball and
Softball Association authority and when the parent and/or
guardian cannot be reached;
2) agree to abide by all the rules and regulations of Triad Jr.
Baseball and Softball Association and will not hold the Village of
North Lewisburg and/or Triad Jr. Baseball and Softball
Association responsible for any accidents or injuries our/my child
may suffer as a result of playing ball in a league.
If you concur, please type your name and today's date below.  
Also, indicate your relationship with the player (i.e., mother/father)
Registration Fee Owed:
Fee Owed:  For 1st child, fee owed is $50.  For 2nd child,
incremental fee owed is $25.  For each subsequent child, the
incremental fee owed is $10.
Please mail checks to:
TJBS
Attention: Treasurer
P.O. Box 84
North Lewisburg, Ohio  43060

Your child will not be fully registered until payment has been
received.

If using Paypal, add $1.75 for fee processing.  Thanks.
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