Transcription of Senior Softball National Identification Card
1 WHAT TO SEND CHECKLISTFIRST TIME APPLICATIONS MUST INCLUDE Player Registration Form Registration Fee Copy of Gov't issued photo ID, such as Drivers License or Passport Clear color photo (No black-and-white of faxed photos)RENEWALS MUST INCLUDE Player Registration Form Registration Fee Clear color photo (No black and white or faxed photos, please) OR, you may call the office and renew over the phone with a credit cardFEE SCHEDULE - CHECK ONE(YEARS TO NEXT 5-YEAR AGE GROUP)$35 = One Season / Age 75+$45 = Two Seasons$55 = Three Seasons$65 = Four SeasonsPlayer Registration FormSenior Softball National Identification CardFor theSenior Softball Tournament SeasonNOTICE: Subscription to Senior Softball News included!
2 (except Canada - Call SSUSA for rates)FIRST TIMERENEWALREGISTRATIONREPLACEMENT ($40 FEE)NEW REGION ($40 FEE)PLEASE TYPE OR PRINT LEGIBLYSSUSA CARD NUMBER, IF ANYNAMENICKNAMESTREET ADDRESSCITYSTATE ZIP CELLDATE OF BIRTHE-MAILAGE GROUPTEAM AFFILIATIONEMERGENCY CONTACTPHONEI hereby certify that the information provided is correct and further agree that it may be verified. Anyfalsification of information will result in disciplinary action including suspension or banishment from SeniorSoftball USA sanctioned tournaments. I understand that on site, this ID card may be required as proof ofidentity before I am permitted to participate in any Senior Softball USA sanctioned SIGNATUREThis completed form must be received 20 days prior to the Tournament you wish to enterMake check payable to: SSUSA Player Registration Mail to: Senior Softball USA 9823 Old Winery Place Suite 12 Sacramento, CA 95827-1720 Phone: (916) 326-5303 E-mail: = Five Seasons
