2008 Lebanon Little League Registration and Permission Form

Child's Name     Date of Birth 
Address     Town 
Parent/Guardian Name     Phone 
Email Address 
School     Age as of May 31, 2008 
Current Year Request Fee # of players Total
Rookie League: Ages 5-6 $25.00 $
T-Ball: Ages 6-8 $40.00 $
B-Ball: Ages 9-11 $75.00 $
A-Ball: Ages 10-12 $75.00 $
Multi-player discount ($10 for each additional child after the first) $
Fundraising Options (check applicable box):
       Parent and child agree to participate in two fundraisers. (Tag Day and Raffle)  
       Parent/child elect to opt out of fundraising commitment -
           $50/child or $100/family maximum.		 $
Total Fee due by March 15, 2008 $
Prior Year Division Played With 
Team Name     Coach 

NOTE: Guardian or parent of child must be a legal resident of Lebanon, Grantham, or Plainfield.
I give permission for

  • (Child's Name) to play baseball in the Lebanon Little League and release the league and its representation from any liabilities and injuries that may result from participation in or the transportation to and from the practices and games.
  • To have my child's picture posted on our Web site. (last names will NOT be used)

Please Circle Yes or No:

  • I have signed and attached the Youth Sports Parent Code of Conduct Form.     YES    NO
  • I am willing to help with coaching or umpiring.     YES    NO
  • My child does not have a pre-existing medical condition OR I have submitted the L.L.L. Medical Release Form.

Signature:___________________________________________  Date 

Parent or Legal Guardian (Print):___________________________________________

For Official Little League Use Only:
Birth Certificate Verified:________  Paid:  Cash $________  Check $________  (check #________)  Post Mark Date:_______
Code of Conduct received:________  Liability Release received:________  Medical Release received:________

Print this form then: Proceed to Liability Release Form