Adult League Registration

    2. Address


    5. Emergency Contact






    12. Consent and Emergency Care Agreement:
    13. I acknowledge that I, the participant, (or authorized guardian) will be using the facilities and participating in this softball league at my (his/her) own risk and I hereby release Therapeutic Recreation for the Disabled, Inc., and its employees and volunteers from liability due to bodily injury and/or damage to property of the participant. I understand that every effort is made to protect the safety of each participant, however, there is risk of injury due to the nature of the activity. I furthermore understand that efforts will be made to contact the emergency contact provided above in the event of an emergency, however, if an emergency contact cannot be reached, by signing below, I hereby authorize an agent or designee of Therapeutic Recreation for the Disabled, Inc. to take such measures and arrange for medical and/or hospital treatment in my behalf. Also by signing below, I understand that my likeness or photos of myself may be used in publicity, brochures or other media.

    15. ***Draw your signature using your mouse cursor or finger (on mobile devices).***

    * Required

    If you would like to pay by check, please click "Register For The 2017 Season". When you come to the payment page, close it, and mail us your check. When we have received your payment, we will mark your registration as complete! Thank you!
    Please mail checks to:
    Therapeutic Recreation
    ATTN: Steve Smith
    243 S. Gersam Ave,
    Hamilton, Ohio

    The Joe Nuxhall Miracle League Fields 501(c)(3)
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