Application

Address:_____________________________City/State_________________Zip:______

Phone #:_____________________ Email:____________________________________

Uniform Size: Pant Size_______________       Shirt Size_________

Did you play in 2011: Yes / No      League:____________________________________

Parents interested in coaching: Yes / No                 Possess Act 33/34 clearances:__________

Heath Insurance which player is insured under: ____________________________________________________________________________

I/We the parents/guardians of the above names player, hereby give my/our approval to participate in any and all McKeesport Youth Baseball Organization (MYBO) activities. I/We assume all risks and hazards incidental to such participation including transportation to and from activities and I/We do hereby waive, release, absolve, indemnify, and agree to hold harmless MYBO, the organizers, sponsors, supervisors, participants and persons transporting my/our child to and from activities, for any claim arising out on an injury to my/our child whether the result of negligence or for any reason to the extent and the amount covered by accident or liability insurance.

Guardians Name:_____________________ Signature:__________________________

Relationship to player:___________________________________________________

All registration forms must e received no later than 3/14/12 and will be processed in the order in which they are received. If payment is not received in full by 4/4/12, MYBO reserves the right to void this application.

Registration Fees are $40 Tee Ball, $50 Instructional, $60 Minors/Majors, $85 Pony/Colt/Super Colt

Check/Money Orders made payable to: McKeesport Youth Baseball Organization (MYBO). Please include a copy of your child's Birth Certificate with this application.

If Mailing Send to:

Jim Barry                                                                                               Mike Shelly

108 Marshall Dr.                                                                                  631 Hazel St

McKeesport, PA 15132                                                                      McKeesport, PA 15132
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For Organizational Use Only

Fee Paid:________________ Date:____________ Balance Due:___________ League Age:__________

Returning Player: Yes / No ________________    Uniform Returned:__________________________

MYBO is an Independent Baseball Organization which is affiliated with The LaRosa Boys/Girls Club of McKeesport and Pittsburgh R.B.I (Reviving Baseball in the Inner City) Program

MYBO is Dedicated to sportsmanship, enthusiasm, discipline, fun and fundamentals.

Check out our website: www.mckybo.com