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NAW-Tryout Register

WBL-NAW Player Registration

Name ________________________________________________Cell _______________________________
Parent Name __________________________________________Cell ______________________________
Address: ________________________________________________________________________________
City: _____________________________________________State:____ Zip: __________________________
School/College: ___________________________________________________________________________

Selected 2019 Tryout Location:

_____  Sunday,  April 7  Lumberton, NC,                                  Purnell Swett HS                             
_____  Sunday,   April 28 Danville, VA                                                 GWHS            
_____  Saturday, May 4, Green Co, VA,                                    Green Co HS         
_____ Sunday, May 5,  Martinsville, VA,                                 Patrick Henry Community College, Hooker Field  
_____   Sunday    May 26, Newport News, VA                                     Strafford University                                        
_____  Sunday, June 6, South Hill, VA,                                    Park View HS  
_____  Sunday, Jun2 23, Beckley, WV                                       TBA   

Payment Options:NAW Tryout FEE:            $25.00

end Check to:                VMarlins, 133 Briarcliff Lane, Danville, Virginia, 24541

Make Payable to:            VMarlins

 Pay via PayPal:                Send to gmvmarlins@yahoo.com              Note: Registration fee for 2019 

 Pay with Credit Card:    Card Name: _______________________________________________________
Type of Card: ______________________________________________________
Card Number: ______________________________________________________
Expiration Date:__________________________  Security Code: _____________

Player and Family Participation Agreement

I, __________________________, will participate in the WBL Tryouts/Events and will follow the rules of engagement as outlined by the coaching staff of the WBL. I understand that I may be dismissed from participation should I conduct my actions in a manner that is not acceptable to the protocol of the program.  I also have the permission of my family to allow the coaching staff to act on my behalf in the event of an emergency that involves my health and welfare.

 Signature: ______________________________________________ Date_______________

Player and Family Medical Insurance Information Agreement

I/We agree to allow myself/our son/daughter to participate under the above conditions of the WBL as stated, and do not hold the WBL liable for any accident, injury, or other liability that results from participation.  We are personally accountable for our entrance into the facilities and we participate in the programs at our own personal risk. I/We also provide the following insurance information to be used for the care of myself/our son/daughter in the event of an emergency.  Signature: ____________________________Date__________

Insurance Company Name _________________________________________________________________
Policy Number___________________________________________________________________________
Address ________________________________________________________________________________
City ______________________________________State ____Zip ______Phone ______________________

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