Chesterfield Senior Softball Registration Form

CSSA 2025 Registration Form
Deadline March 31, 2025

In 2025 our league plays from April to August.
The co-ed league plays on Mondays.
The men's league plays on Thursdays.

Complete this form, print it, and mail your completed Registration form with your check to :
Chesterfield Senior Softball Association
PO Box 2713
Chesterfield VA 23832

Men's League
Thursday Night $70.00
Spring Co-ed League Monday Night $70.00
Our leagues play from April through August in 2025.
Out of County residents add $15 to the registration fee.



Player Information

Name Home Phone
Date of Birth Mobile Phone
Home Address Email
City or County Zip Code
Shirt Size S M L XL 2XL Preferred Number
Emergency Contact Phone Number
Positions Played P C 1st 2nd 3rd SS OF Preferred Position #1 _________ #2 _________ #3 _________

Men's League

Posse Young Virginians Players Hog Polers
I am registering with a new team Team Name:
I am a new player and need a team

Coed League

I would like to play with Relationship to player
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

Leadership Opportunities

Leadership/Participation: Please indicate if you may be willing to serve CSSA in some capacity: (Checking the box only obligates you to discuss the possibilities with a board member.)
Team Manager Board Member Tournament Committee
Rules Committee Fall Ball Committee Other / Not sure

Registration Fees

Men's League (50+) $70 $
Coed League (Men 50+; Women 40+) $70 $
Non-Resident Fee $15 $
Late Fee (after May 1, 2025) $10 $
Total $

***Sponsors: If you want to sponsor or know of a company that may want to be a team sponsor or otherwise donate to our league, please contact Jeff Davis at 804-441-1322.

Player Release and Waiver of Responsibility

Every player must sign this form to be allowed to play.


PLEASE READ BEFORE ACKNOWLEDGING:

In consideration of the acceptance of my application for registration in the Chesterfield Senior Softball Association (CSSA), I have and do hereby assume all risks connected to the Chesterfield Senior Softball Association activities. I hereby for myself, my heirs, executors, administrators, and assigns, waive and release and discharge any and all rights and claims for damages and/or losses which I may have against the Chesterfield Senior Softball Association, its officers, board members and/or agents, for any and all activities connected with the Chesterfield Senior Softball Association. I understand the meaning of this agreement and my signature hereon indicates that it is a voluntary act on my part.

Player Name (Please Print )
Cell Phone Number
 
_________________________________________
Signature
__________________________________________
Date




For office use only

Check # ______________ Balance ______________
Rec'd by ______________ Cash ______________
Date Rec'd ______________ Total Paid ______________