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Chesterfield Senior Softball Association

CSSA 2019 Registration Form

Please complete , print, sign it and mail it to
Chesterfield Senior Softball Association
PO Box 2713
Chesterfield, VA 23832

Name
Date of Birth
Home Address
City
Zip Code
Residence:
(County or City)
Home Phone
Mobile Phone
Email
   
Shirt Size
Preferred #

Competitive Division

Men's League
$50.00


Coed League
$50.00



Recreational Division

Rec Leagues
$50.00


Team assignments: Priority assignments will be given to family members or first year players with individuals who brought them into the league. Only (1) family/friend assignment per player
   



Registration Fees

  Resident Non-Resident Amount
Mens League (50+) $50 $65
Coed League (Women 40+, Men 50+) $50 $65
Late: After March 1, 2019 $10 $10
TOTAL DUE    
All blanks are to be completed in order to be eligible for league play. You must ALSO sign at the bottom
Note: Every player must sign this form to play.
The Chesterfield Senior Softball Association is a voluntary program. I do hereby waive, release, absolve, indemnify and agree to hold harmless the Chesterfield Senior Softball Association and it's representatives for any claim arising out of injury whether the result of negligence or for any cause and do further assume the responsibility for my conduct.
Signature __________________________________________________________
Date ___________________________