SOUTHERN SOFTBALL ASSOCIATION OF AMERICA
                                         Official Youth Team Roster

Team Name___________________________________________________Sanction Card No.________________
__
Age/Class_______FP___SP___Phone(Home) (_______) _______________(Work) (________) _________________

Manager's Name_________________________________________ e mail________________________________

Mailing Address_______________________________________________________________________________

City_______________________________________State__________________________ZIP_________________

Team Insurance: Provide Copy Of Coverage or policy# and carrier_______________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________
         PARENT OR LEGAL GUARDIAN'S AGREEMENT AND PERMISSION TO PARTICIPATE
I, parent/guardian, of the below named player, in consideration of permitting said player to participate in the SSAA Youth Program  ,
do hereby  for myself, my heirs, executors and administrators,waive and release any and all rights and claims that I might have
against SSAA the local metro and State associations, its sponsors, their agents or representatives, for any and all injuries or losses sustained
, arising or suffered by said player while competing in or in connection with the play of SSAA, and hereby contract and agree to hold
harmless and to indemnify it from and on account of any damage suffered or sustained by SSAA by reason of said player being injured.


Parent's/Guardian's Signature should be on the same numbered line as player's name. 
By signing this roster, parent/guardian agrees to the above statements and verifies that the date of birth is correct
_____________________________________________________________________________________________________________
  PRINT or TYPE PLAYERS NAME             / DATE OF BIRTH /  PARENTS or GUARDIANS SIGNATURE  /   RELATIONSHIP _______________
1.________________________________!_____________!_________________________________!_____________________________
2.________________________________!_____________!_________________________________!____________________________
3.________________________________!_____________!_________________________________!____________________________
4.________________________________!_____________!_________________________________!____________________________
5.________________________________!_____________!_________________________________!____________________________
6.________________________________!_____________!_________________________________!____________________________
7.________________________________!_____________!_________________________________!____________________________
8.________________________________!_____________!_________________________________!____________________________
9.________________________________!_____________!_________________________________!____________________________
10._______________________________!_____________!_________________________________!____________________________
11._______________________________!_____________!_________________________________!____________________________
12._______________________________!_____________!_________________________________!____________________________
13._______________________________!_____________!_________________________________!____________________________
14._______________________________!_____________!_________________________________!____________________________
15._______________________________!_____________!_________________________________!____________________________
16._______________________________!_____________!_________________________________!____________________________
17._______________________________!_____________!_________________________________!____________________________
18._______________________________!_____________!_________________________________!____________________________
19._______________________________!_____________!_________________________________!____________________________
20._______________________________!_____________!_________________________________!____________________________

IMPORTANT: Each team manager shall be responsible to keep copies of birth certificates, ect. at all times in case of protests
                                                          - TEAM MANAGER'S  AFFIDAVIT-               
I, the manager of the above team, do hereby state that all of the above information above is correct and that this roster does not include any
assumed names and that each player conforms to the rules governing  Team Membership. I further agree that each player has full
knowledge and has approval of his or her name being placed on the above roster. I agree to accept all terms specified in Conditions of entry.

Date______________________Manager's Signature__________________________________________________


Date_____________________  SSAA Director's Signature_______________________________________________