2019 Registration Form (Stratford Girls Softball)
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2019 Registration Form
Player to be Registered
Last Name:
*
First Name:
*
Date of Birth
*
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Primary Phone
*
Example: ###-###-#### x###
Phone Number Location
*
Home
Cell
Work
Primary Email
*
PLEASE NOTE: SMGSA uses this email as it's primary method of communication with players. A copy of this submission will be sent to this address when complete.
Unit/Street No.:
*
Street Address:
*
City:
*
Postal Code:
*
Medical Concerns:
Registrant (Parent,Guardia or Adult Player)
This Section to be completed by parent guardian or player over the age of 18
Parent / Guardian 1 First Name
*
At least one parent / guardian name is required
Parent / Guardian Last Name
*
Parent / Guardian 1 Phone
Example: ###-###-#### x###
Phone Number 1 Location
Home
Cell
Work
Parent / Guardian 1 Email
Example:
[email protected]
Parent / Guardian 2 First Name
Parent / Guardian 2 Last Name
Parent / Guardian 2 Phone
Example: ###-###-#### x###
Phone Number 2 Location
Home
Cell
Work
Parent / Guardian 2 Email
Example:
[email protected]
Registration
Team Registering for:
*
Select One...
Rookie Ball (2011/ 2012 / 2013 / 2014)
Mite - HP (2009 / 2010)
Squirt - HP (2007 / 2008)
PeeWee - HP (2005 / 2006)
Bantam - HP (2003/2004)
Bantam - Rep (2003 / 2004)
Midget - HP (2000 / 2001 / 2002)
Ladies League
Vollunteer/Refund Opportunities
Please consider helping out. SMGSA needs lots of volunteers to make our program work. In order to receive a refund of $40.00 Per Family. Please fill out this section
Are you interested in volunteering with SMGSA?
*
Yes
No
Please consider helping out. SMGSA needs lots of volunteers to make our program work.
Volunteer Name
If yes, where would you like to help?
Head Coach
Assistant Coach
Parent Convenor or Helper for Rookie Ball
Parent Rep for Team
Board Member
Booth (1 Shift, 2 Hours, 3 Times Per Season)
Maintenance (5-6 hours of general work around the park)
Bingo (1 Bingo during the season from 5pm-10pm)
Please select all that apply
If selected coach or parent rep. Please identify the team you would like to be involved with.
Select One...
Rookie Ball
Mite - HP
Squirt - HP
Novice - Rep
Novice/Pee Wee - HP
Bantam - HP
Midget - Rep
Junior
If selected Booth. Please identify when you are available
Example: Weekends, Weekdays, During my daughter's game, Not wednesday....
Player Emergency Contact
Name of Contact:
Contact Phone:
Example: ###-###-####
Fees
Cheque made payable to S.M.G.S.A. Mail your cheque to (S.M.G.S.A , 12 McFarlane St, Stratford, ON, N5A 1P7 - c/o Cheryl Fountain, SMGSA Registrar)
Select team registering for
*
Select One...
Rookie Ball (2011-2014) -- $35.00
Mite (2009/2010) -- $165.00
Squirt (2007/2008) -- $165.00
Peewee (2005/2006) -- $165.00
Bantam - HP (2003/2004) -- $165.00
Bantam Rep (2003/2004) -- $400.00
Midget - HP (2000 - 2002) -- $165.00
Ladies League (Open to all Ages) -- $165.00
Rep players pay both the Huron-Perth fee $165.00 and Rep Fee $235.00 (total Fee $400.00) Rep Fee cheque may be post dated April 1, 2018 ($235.00)
Out of Town Fee
*
Select One...
Resident of the City of Stratford
Non-Resident (I live outside of Stratford) -- $20.00
Please Identify if you live inside the city limits. If you do not pay taxes to the city of Stratford you will need to pay a Non-Resident Fee of $20.00
Payment Type
*
Select One...
Cheque
PayPal (4% Fee will be Added)
Other
Payment can be made via Cheque or Paypal. (If other payment options are needed please contact Cheryl Fountain) This form will automatically take you to a Paypal option. You do NOT have to pay with Paypal. If you do pay using Paypal there will be a 4% Fee/Tax added to your registration. This is to cover the cost of using Paypal.
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Fri Feb 15, 2019
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Stratford Girls Softball Association
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