Fast-Pitch Softball Showcase Acceptance | Georgia Athletic Coaches Association

DETAILS

Congratulations on the All-Star selection of your player. Please complete this form and submit ASAP.

All forms must be submitted online, but you can click on the following link to print out a blank copy: Softball Showcase Form. This can be given to and signed by the parent.

MEDICAL / PHYSICAL

Please upload your child's physical here. It is required This can be done by scanning the physical to your computer and uploading here.

A parent can take a picture of their child's physical and upload it below...either from their computer or phone.

Player Physical*

PLAYER INFORMATION

Player Name*

First Last

Email*

Player Picture*

Gender*

Grade*

Date of Birth*

Place of Birth*

High School*

Coach's Name*

First Last

Coach's Email*

Coach's Cell Phone*

Weight*

Height*

Shoe Size*

Shirt Size*

Pant Size*

Dominant Hand*

Address*

This is the address where your picture will be sent.

Street Address City State ZIP Code

Will you be on scholarship for college?*

Please give us the name of college/university*

Will you attend college if you do not have a scholarship?*

Where will you attend?*

List all high school sport honors*

350 character max

List all academic organizations that you belong to:*

350 character max

Please describe the most memorable sporting event that you were involved in:*

350 character max

Do you have asthma or allergies?*

Please explain*

Do you have diabetes?*

Date of last tetanus shot?*

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name*

First Last

Email*

Address*

Street Address City State ZIP Code

Parent/Guardian #2 Name

First Last

Home Phone*

Cell Phone*

Night-Time Phone*

Are you covered by insurance?*

Insurance Company*

Group Number*

Policy Number*

Branch of Service*

Is your child allergic to any medicine?*

Please list*

Is your child taking any medications?*

Please list*

Please list any serious injuries, illness or circumstances we should be aware of before administering care:*

Enter N/A is this does not apply to you

Do you know of any reason why you should not participate in the all-star game?

Please Explain:*

EMERGENCY CONTACT

Every attempt will be made to contact you in case of injury. Should this not be possible or practical, please list the name of a relative who can authorize treatment.

Name*

First Last

Relation*

Phone*

SIGNATURES/ATTESTATIONS

Player Attestation*

I hereby accept the Georgia Athletic Coaches Association's invitation to play in the North-South All-Star Softball Showcase being held at The University of West Georgia at West Georgia Softball Complex, 1601 Maple Street, Carrollton, GA 30118. I agree to abide by the rules and disciplines set forth by the officials of the Georgia Athletic Coaches Association. I understand that I am to report to the North-South All-Star Softball Game on the dates listed above.

Parent Attestation*

Please check all:

I verify that the above information to be true and accurate to the best of my knowledge.
I do hereby approve emergency treatment, as deemed necessary, by the hospital and/or medical staff (physician, athletic trainer)on site for my son/daughter listed above.
I give this consent with full knowledge and assumption on my part for any and all financial responsibilities incurred as a result of participation in the All-Star Softball game and practices. My insurance company will serve as the primary coverage for my child. The Georgia Athletic Coaches Association's insurance will be secondary insurance.
I hereby give my consent for the student named above to engage in approved sports activities, related to the North-South Softball All-Star camp and Game. It is my clear understanding that participation in athletics activities (e.g. football, basketball, baseball and softball) creates a risk normally associated with such activity. I agree not to hold the Georgia Athletic Coaches Association or anyone acting on its behalf responsible for any injury occurring to my son/daughter in the proper course of such athletic activities or travel. I further give my permission for the appropriate all-star association staff members or their designees (physicians, athletic trainers, student trainers, coaches) to render emergency treatment or authorize medical treatment by a hospital and/or physician or medical staff.

Player Signature*

Parent/Guardian Signature*

Payment

If paying online, please click the submit button once. You will be directed to PayPal for payment.

If paying by mail, please mail check to:

GACA
PO BOX 597
ELBERTON, GA 30635

Submission of form without payment does not qualify your athlete for the All-Star game. Payment must be collected in order for your athlete to participate in the All-Star game.

How will you be paying?*

All-Star Cost*

Price: $300.00

Processing Fee*

Price: $12.00

Total

$0.00

All-Star Softball Showcase Package

DETAILS

MEDICAL / PHYSICAL

PLAYER INFORMATION

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT

SIGNATURES/ATTESTATIONS

Payment