Little League Verification Form – Fill Out and Use This PDF

LITTLE LEAGUE® BASEBALL AND SOFTBALL

Tournament Player Veriicaion

Baseball	Sotball

Date Requested __________________

League Name ______________________________________ League ID # ______________________________

Player Informaion and Documentaion

Player Name _________________________________________ Date of Birth____________________

(Must be name as shown on the birth documentaion)

Type of Age Proof (Original must be presented and copy must be atached)

Board of Health/Registrar of Vital Staisics	Federal/Military	In-Lieu Statement (necessary document from all four groups)
Address of Parent or Legal Guardian
Street Address	City	State	Zip Code

Residency Proof (If residence changes to outside the league boundaries, a Regulaion II(d) form must be prepared and atached to this form. If player has writen approval via the Charter Commitee of Williamsport, Pennsylvania, atach copy of writen approval to this form.)

Driver’s License	Local (Municipal) Records	Medical Records
Voter’s Registraion	Support Payment Records	Military Records
School Records	Homeowner/Tenant Records	Internet, Cable or Satellite Records
Welfare/Child Care Records	Uility Bills	Vehicle Records
Federal Records	Financial Records	Employment Records
State Records	Insurance Documents
	(All documentaion must be atached to this form)

Veriicaion

Parent or Legal Guardian Agreement: By my signature below, I cerify that all the informaion provided for this Tournament Player Veriicaion is true and correct and provides the necessary documentaion required by Litle League to verify league/tournament age and residence eligibility. If the Charter/Tournament Commitee subsequently inds that the informaion submited as acceptable documentaion regarding league/tournament age and residence eligibility now shows that the previously submited informaion/documentaion was falsiied, misrepresented or insuicient then Litle League Baseball, Incorporated reserves the right to impose sancions and/or penalies on all appropriate paries, including but not limited to players, coaches, league oicials and/or the league which could result in suspension and/or terminaions with Litle League Baseball, Incorporated.

Name (Printed) of Parent/Guardian

Signature of Parent/Guardian

Date

League President’s Veriicaion: I have reviewed and veriied that the informaion presented here is true and correct and provides the necessary documentaion required by Litle League to verify league/tournament age and residence eligibility. If the Charter/Tournament Commitee subsequently inds that the informaion submited as acceptable documentaion regarding league/tournament age and residence eligibility now shows that the previously submited informaion/documentaion was falsiied, misrepresented or insuicient then Litle League Baseball, Incorporated reserves the right to impose sancions and/or penalies on all appropriate paries, including but not limited to players, coaches, league oicials and/or the league which could result in suspensions and/or terminaions with Litle League Baseball, Incorporated.

Name (Printed) of League President

Signature of League President

Date

District Administrator’s Veriicaion: I have reviewed the residency documentaion and veriied the players original birth ceriicate and the informaion presented here is true and correct and, to the best of my knowledge appears to be acceptable under Litle League standards.

Name (Print) of District Administrator

Signature of District Administrator

Date

NOTE: This form and atached original documentaion must be retained by the player’s parent or legal guardian as well as a copy retained by the

local league. It is recommended that the District Administrator also maintain a copy.