City A value is required. Zip Code A value is required.Invalid format.

League Age (age on April 30, 2010) A value is required. Birthday A value is required.Invalid format.mm/dd/yyyy

Jersey Size Please Select a Size Youth Medium Youth Large Youth XL Adult Small Adult Medium Adult Large Adult XL Adult XXL Please select a size.

Pants Size Please Select a Size Youth Medium Youth Large Youth XL Adult Small Adult Medium Adult Large Adult XL Adult XXL Please select a size.

Dad's Name Dad's Home Phone

Dad's Cell Phone Dad's Email Address

Mom's Name Mom's Home Phone

Mom's Cell Phone Mom's Email Address

Did your child participate in a Dixie Baseball program other than Youngsville last spring? Yes No

If yes, in which parks and recreation program did he or she participate? If yes, please select Louisburg Parks and Rec Bunn Youth Recreation League Other

Requests or Comments

TERMS AND CONDITIONS - I/We, the parents/guardians of the above-named candidate for a position on a YPRD team, hereby give my/our approval to participate in any and all YPRD activities, including transportation to and from the activities. I/We know that participation in any sport may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify, and agree to hold harmless YPRD, the organizers, sponsors, supervisors, participants, and persons transporting my/our child to and from activities from any claim arising out of any injury to my/our child whether the result of negligence or for any other cause.

By checking this box and submitting this application, I affirm that I have read and agree to the terms and conditions as set forth by the Youngsville Parks and Recreation Department. You must agree to the terms and conditions to register your child online..