BRONXCHESTER LITTLE LEAGUE C/o Vincent Firsching 1553 McDonald Street Bronx, N.Y. 10461 www.bronxchesterlittleleague.com

REGISTRATION FORM 2010 SEASON Registration will be held September 12th & 13th the 19TH & 20TH 2009, From 10:00AM till 2:00PM. You can also mail the form, with payment and a copy of the birth certificate to the above address.( NO LATER THAN OCT. 31 ST , 2009)

PLAYER’S NAME______ADDRESS______APT#______CITY,STATE,ZIP______CELL/PHONE______DATE OF BIRTH______E-Mail address______

TEAM LAST SEASON______SCHOOL______

FATHER’S NAME______OCCUPATION______MOTHER’S NAME______OCCUPATION______MEDICAL COVERAGE______EMERGENCY #______

WOULD YOU LIKE TO BE A – COACH______MANAGER______(PLEASE CHECK ONE!!!! FIELD WORK WILL BE REQUIRED)

THE FEE IS FOR THE FOLLOWING DIVISION’S ARE AS FOLLOW’S: T-BALL – ages 5 years old - $90.00 JR. MINOR – ages 6 to 7 years old - $150.00 FARM – ages 7 to 8 years old - $160.00 MINOR – ages 9 to 10 years old - $160.00 MAJOR – 11 to 12 years old - $160.00 JR. /SENIOR – 13 to 14 years old - $200.00 SENIORS – 15 to 16 years old - $200.00 GIRLS SOFTBALL – 9 TO 12 years old - $160.00 THIS INCLUDES: TEAM SHIRT, PANTS, HAT, SOCKS, AND THE FEE IN CHANCE BOOKS. (You sell the chance books, you keep the money.) Chance books will be given out with uniforms and schedules in March. ______(BE ADVISED NO REFUNDS WILL BE GIVEN AFTER JANUARY 1 ST 2010)______(office use only) LEAGUE DIVISION______LEAGUE AGE______METHOD OF PAYMENT______RECEIVED BY______DATE______