NSA of Washington

NSA SLOWPITCH - WASHINGTON

P.O. Box 2031

OFFICIAL ROSTER

Sumner, WA  98390

State Director

253-332-0953

Regional Director

Team Name

TEAM CLASS/DIVISION

City/State

Sanction Form Number

TEAM MANAGER AND PLAYERS, READ THE FOLLOWING STATEMENT BEFORE COMPLETING AND SIGNING

In consideration of being permitted to participate in the N.S.A., I hereby agree for myself, successor, heirs and assigns, Release and forever discharge National Softball Association, Inc. (N.S.A.), their employees, officers, and directors

from all claims, actions or judgements I may have to claim to have against N.S.A. for all personal injuries, including death, and injuries to property, real or personal, caused by an or arising out of my participation in the N.S.A. - either Leagues

or Tournaments, I futher agree for myself, successors, heirs and assigns to indemnify and hold N.S.A. harmless from all claims and suits for personal injuries, including death, damages to property caused by my act of omission arising out of

participation in the N.S.A., and from all judgements recovered and from all expenses incurred in defending said claims or suits. I further agree that my photographs, pictures or movies taken or made by N.S.A., their employees, officers and directors,

in connection with my participation in the N.S.A., or by any person, corporation, or association authorized by N.S.A. I am in good health and have no physical condition that would prevent me from participating in the N.S.A. event.

I, THE UNDERSIGNED, HAVE READ AND UNDERSTAND THE FOREGOING RELEASE.

_NO.

_{PRINT OR TYPE PLAYERS NAME}

_{PLAYER'S SIGNATURE}

_{STREET ADDRESS/CITY/STATE}

_{ZIP CODE}

_{DRIVERS LIC. #}

_{CONTACT PHONE}

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N.S.A. Requirements. Roster must be signed by all players. The player is automatically ineligible if a signature appears on more than

Team rosters must be submitted to Regional Director upon Qualifying for State or National Championship.

one roster, unless the player has a written release dated and signed by the team manager fo the team for which the player will not be a

TEAM MEMBERS MAY BE ASKED TO PROVIDE A POSITIVE I.D. UPON REQUEST.

member. The release must be filed with the Regional Director before the teams play in a tournament leading to a State or National Championship.

Signature of Team Manager

Manager's Name (Print)

TEAM MANAGER'S AFFIDAVIT

I am the manager of the above team and guarantee all of the information supplied above is correct

Manager's Address (Print)

to the best of my knowledge and that all of the players signed the above in their handwriting and they

Home Phone

are eligible to compete with my team in the championship play of the NSA and agree to be bound by

City                                   State                            Zip

the rules and regulations of NSA. I also guarantee that if my team is a church team, all members of my

Office Phone

team are members in good standing of the church we represent.

Cell Phone

Email Address