Alameda Junior Baseball


		2010 REGISTRATION FORM

		Athlete Name: _______________________________________________ Date of Birth _____ - ____ - ______ Age as of 4/30/10* _________
		Parents / Guardians Name: Father ______________________ Mother _____________________________ Guardian _____________________

		Address: _________________________________________________ City ___________________ State _____ Zip Code _______________

		Phone Numbers Home: _____-_____-______ Work: ______- ______-_______ Cell: ______-______-______ Cell: ______-______-______

	Email Address: __________________________________________ School Attending: ______________________ Grade: ___________

	Is your child new to the Alameda Baseball Program? Yes ____ or No _____ Last Years Coach ___________________

Do you Prefer: Same Team ______ Different Team (Coaches Name) _________________ Open Draft _____

Registration Fees

Age	BORN BETWEEN 5-1 and 4-30	DIVISION	FEE
5-6-7	2002-2005	TEE BALL	$85.00
7-8	2001-2003	COACH PITCH	$85.00
7-8	2001-2003	MACHINE PITCH (Tryout Required)	$85.00
8	2001-2002	KID PITCH (Tryout Required)	$140.00
9	2000-2001	1ST YR MIDGET (Tryout Required)	$140.00
10	1999-2000	2ND YR MIDGET	$140.00
11	1998-1999	1ST YR JUNIORS	$140.00
12	1997-1998	2ND YR JUNIORS	$140.00
13	1996-1997	1ST YR INTERMEDIATES	$150.00
14	1995-1996	2ND YR INTERMEDIATES	$150.00


	If you are not resident of Lakewood, an extra $10.00 fee will apply at the time of registration.

		$25.00 service charge on returned checks and additional charges may be imposed in accordance with State Laws.

		2010 Registration Fee: $_______ Non-Resident Fee $ ________ Additional Fees $_________ Total Amount $______

		*Registrations are Due by February 14th, 2010*

	*Refund requests prior to March 1st, 2010 must be in writing and are subject to a $25.00 administration fee *

	* NO refunds will be given after March 1st, 2010 *

	* If you have and questions please call our Registration Coordinator @ 720-495-6136 *

			Mail Registration To:

AJBA

		P.O. BOX 151135

LAKEWOOD, CO. 80215 - 9135

				CONSENT AND RELEASE FORM I, the undersigned parent and/or guardian, agree that baseball is an activity in which injury can occur and I specifically agree to protect and hold harmless and waive any and all claims against the Alameda Junior Baseball Assc., its players, members, coaches, Directors, Officers, and other volunteers and their heirs and assigns; and the Jefferson County Junior Baseball League (JCJBL) and itsmembers, volunteers, employees, Directors, Officers, and their heirs and assigns in the event that the players named above or any member of his or her family is injured while taking part or attending an event sanctioned by AJBa or JCBJL. PARENT / GUARDIAN: _____________________________ DATE ______________________