Wellston Community Sports Association, Inc.
Universal Player Application

Print this application on your computer, fill it out, and return to one of these businesses:
Brodigan's Sporting Goods, 7 South Ohio Av, Wellston, Ohio 45692
Ron's Trophies, 414 East C St, Wellston, Ohio 45692
Place your check or cash and the application in a sealed envelope.
All player fees are $25
All applications MUST BE returned by the registration deadline posted on this website.

SPORT: __Soccer __Basketball __Volleyball __ Baseball __ Softball __ Cheerleading

Name of Participant_________________________________________________

Address__________________________________________________________

Home Phone_________________________ Birthday __________ Age________

E-mail address______________________________________ Grade_________

Shirt Size: Check One: ___ YOUTH 6-8 ___YOUTH 10-12 ___YOUTH 14-16

___ADULT Small ___ADULT Medium ___ ADULT Large ___ ADULT Extra Large


WAVIER AND RELEASE

I/We ____________________________________ (parent/guardian name) certify the
above information is true. We will not hold the Wellston Community Sports Association, Inc.
responsible for injury or death to any participant of a Wellston Community Sports Association, Inc.
sponsored sport and/or activity.

The Wellston Community Sports Association, Inc. does not provide medical insurance for any
player or participant. Insurance coverage must be provided by the parent and/or guardian.
Team membership is selected by a roundtable draft of eligible participants.
All parents must sign and adhere to the Parent's Code of Conduct.
Checks are payable to the Wellston Community Sports Association, Inc..
All fees are non-refundable and all decisions and rule changes are final.

I/we agree to the terms and conditions stated above.

Parent/Legal Guardian signature_______________________________________

Today's date______________________________

Thanks! We'll contact you soon.
Form R2
WCSAI-05/rbc