PYO Player Registration Form

P.O. Box 8093
West Chester, Ohio 45069

Spring - 2024

Registration Form / Player Contract

Player Information

Last Name

First Name

Sex

Street Address

City

State Zip Code

School Attending or Planning to attend for Kindergarten

Heard About PYO (select from list below)

Player's Date of Birth (mm/dd/yyyy)

Player's Home Phone (use Mobile if no Home Phone)

Last Year's Division

Requested Division This Year (see age chart)

Last Year's Coach/Team

I would Like to Play on the Same
Team as Last Year

Yes No

Requested Coach

Positions Played (Check all that apply)

Outfield 3B SS 2B 1B Pitcher Catcher

Shirt Size

Youth Sizes: S M L
Adult Sizes: S M L XL

Parent / Legal Guardian Information

Parent (1)

Last Name	First Name
	* *
Email Address	Mobile Phone
* Invalid Email Address
Employer	Work Phone

Parent (2)

Last Name	First Name

Email Address	Mobile Phone
Invalid Email Address
Employer	Work Phone

I will volunteer my help in one or more of the following areas

(Check all that apply)

Coach

Assistant Coach

Concessions

Painting Projects

Carpentry Projects

Tournament Helper

Wherever Needed

I'd Prefer to Contribute $20 in Lieu of PYO Volunteer Service

I would like more information in being a PYO team sponsor

I would like more information about being an umpire. (Umpires are paid on a per game basis)

Comments

I hereby grant my son/daughter permission to participate in all baseball/softball activities, including clinics and post-season tournaments not specifically scheduled. I acknowledge that these activities may require travel in various modes of transportation, with accomidations and meals in various establishments. I acknowledge that my son/ daughter participates in all activities at his/her own risk. In consideration of your permitting him/her to participate, I hereby accept any inherited risk of play or travel and hereby release the Pisgah Youth Organization and/or any other national or local organization/association with which the Pisgah Youth Organization may affiliate, and the officers, coaching staff, sponsors, volunteers, umpires, employees, agents, affiliates heirs, successors, and assigns of each from any responsability that you or they might have regarding the health and physical condition of my son/daughter during his/her participation. On behalf of myself, my son/daughter, our heirs, executors and assigns , I further release and forever discharge al of the above individuals and entities from any and every claim, demand, right or cause of action either in law or in equity arising from my son/daughter's participation in all activities.

By accepting this agreement, I agree to indemnify and hold harmless all of the above individuals and entities from any claim made in derogation of this release. In addition, by accepting this agreement I acknowledge that I have read, understand, and agree to the Mail Distribution Policy, Members Handbook, and the Coach and Parent Code of Conduct

PROCESS REGISTRATION PAYMENT

Payment Item		Amount
Registration Fees
PYO Entry Fees What's this?
Fee in Lieu of Volunteering
Late Registration Fee What's this?
Additional Contribution
Kroger Card Credit What's this?

Total

PYO requires that each family who has a child that participates in PYO functions join the organization. The entry fee per family to join is $90.00, paid in 1/3 increments the first three years of the child's participation.

Registrations received from 10/14/2011 through 4/1/2012 were not subject to a late fee. Registrations on or after 4/2/2012 are subject to a $20.00 late registration fee.

SSL Cert

PROCESS CREDIT CARD PAYMENT

Credit Card Type
Credit Card Number
Expiration Date
Cardholder First Name
Last Name
Address-1
Address-2
City
State
Zip Code
Card Verification Value	What is this?

The Verification Code is a three-digit number on the back of your credit card. The full credit card number is reprinted in the signature box and at the end of the number is the Verification Code.