SYAA 2008 KEN BERRY FALL  LEAGUE  TEAM REGISTRATION

Limited availability.  First come basis.  No Reservations without Complete Roster and Full Payment

This is a SOFTBALL_______ or BASEBALL_____ registration.  (Please check one)

Team Name:                                                                                                                                                                           

                                                   10 & Under         12 & Under               14 & Under               **High School         __ 

Games Played in 2008                                                            Number of Tournaments Played in 2008                                

Manager’s Name:                                                                                                                   _________                                                

Address:                                                                                                           __________                                                                     

Phone #:                  H                              W                                C__________                 Email                                                                                   

CHECK ONE:  Full Fall Season ($700.00 for 10 games for 12U and over)                       10U ONLY Full Fall Season ($300.00 for 5 games)  _____

***High School – Any player still in High School for the 2008-2009 school year***

PARENTAL WAIVER AND CONSENT FORM AUTHORIZATION:

As the parent or legal guardian of the child named below, I hereby give my full consent and approval for my child to participate as a team member in the

baseball/softball program and activities of the Southwest Youth Athletic Association for the current season.  I understand that there are certain risks of injury

inherent in the practice and play of this sport and I am willing to assume these risks on behalf of my child.  I hereby certify that my child is fully capable

of participation in the baseball/softball program and that my child is healthy and has no physical or mental disabilities or infirmities that would restrict

full participation in these activities.  In addition to giving my full consent for my child’s participation, I do here by waive, release and hold harmless

the Southwest Youth Athletic Association (dba: Ken Berry League), it’s officers, coaches, sponsors, supervisors and representatives for any injury that

may be suffered by my child in the normal course of participation in the baseball/softball program and the activities incidental thereto, whether the

 result of negligence or any other cause.  I also understand and agree that the below named player shall not be covered by any insurance held by

the Southwest Youth Athletic Association unless and until this player’s team registration has been fully completed and returned to SYAA.  In

addition, I understand that any insurance held by SYAA is secondary to any accident, disability or health insurance that a participant may be covered

under.  I have attached a certified birth certificate for the below named player.

** ATTACH CERTIFIED BIRTH CERTIFICATES FOR EACH PLAYER ON THE BELOW ROSTER. **  S.Y.A.A. will not provide uniforms or

 equipment.  Uniforms and equipment are the responsibility of the individual teams.

Team Roster:

 Make checks payable to SYAA

Mail Registration Form and applicable fee by August 15, 2008 to:

SYAA dba Ken Berry League,  PO Box 4967, Topeka KS  66604

For information -- Geoff Dahlman 249-1751 (Baseball)  or Shane Pierson (Softball)  478-2503