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CSSA 2013 Registration Form

Complete the registration form below, print it, complete it, sign it and mail it with your check to
CSSA
Lacy Lusk, League Treasurer
901 Buford Oaks Circle
Bon Air, VA 23235

Also, remember to Register to get access to the rest of this web site.

 

CSSA 2013 Registration Form

Complete this form, print it, sign it and mail this form with your check to the address below
Registration Form
Name
Birth Date
Address
City
Zip Code
Residence(County or City)
Home Phone
Work Phone
Cell Phone
Email
 
Check if you will allow other players (but not the general public) to view your phone
Mens League (Check One)
Headliners

 
Co-ed League (Check One)
Thunderbirds

 



Form Deadline for registration (for returning members to sign up for the teams on which they played last year) is March 1, 2013
*** IMPORTANT ***If your fee and form have not been received by the deadline, you WILL be placed in the player pooldraft
FEES
  Before June 30 June 30 and after
Co-ed League (Women 40+, Men 50+) $70 $70
Mens League (50+)) $70 $50
  $70 $70
Non-resident of Chesterfield County (in addition to the league fee) $15 $15
Total Due
All blanks are to be completed in order to be eligible for league play. You must ALSO sign at the bottom

 

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 ITS 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:
Please complete the entire form above and enclose a check for the total amount due to: 
CSSA c/o Lacy Lusk
League Treasurer
901 Buford Oaks Circle
                Bon Air, VA 23235

Visit our web site at http://www.ChesterfieldSeniorSoftball.com

 
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