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Stacey Klimovitch Gala Day - 2nd November 2025
School Softball Gala Day
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Event registration
Details
Rep Policy Acknowledgement Form
Sun 01 Jan 2023 00:00 — Wed 31 Dec 2025 00:15
Stevenson Park Softball Diamonds, Stevenson Park, Stevenson Ave Mayfield 2304
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Are you attending this event?
Yes
No
Maybe
Basic details
First name*
Last name*
Phone number*
Email address*
Address*
Additional information
Please list any relevant medical information Eg: Asthma, epilepsy, allergies, diabetes, and any other relevant information about current medical condition*
Max 255 characters
Please list any current medication that needs to be administered at the state championships*
Max 255 characters
Please list any injuries that have occurred in the last 24 months*
Max 255 characters
Please list any current injuries*
Max 255 characters
Glasses/contact lenses worn?*
Please select...
Yes
No
Emergency Contact Name*
Emergency Contact Number*
Emergency Contact Relationship to Player*
Do you wish to purchase a MALE playing shirt ($40)?
Please select...
No
XS
S
M
L
XL
2XL
3XL
4XL
5XL
6XL
Do you wish to purchase a FEMALE playing shirt ($40)?
Please select...
No
6
8
10
12
14
16
18
20
22
24
26
28
30
What Number do you want on your shirt? (list 3 in order of preference)
Do you want your surname on your playing shirt?
Please select...
Yes
No
Do you wish to Purchase Socks ($15)? List size and quantity (XS, S, M, L, XL)
Do you wish to purchase a hat ($30)?
Please select...
No
Flexfit S
Flexfit M
Flexfit L
Adjustable Cap
Visor
Do you wish to purchase a hoodie ($70)?
Please select...
No
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Do you wish to purchase a jacket ($95)?
Please select...
No
XS
S
M
L
XL
2XL
3XL
4XL
5XL
I have read and understood the NDSA Representative Program Policy and agree to adhere to this policy in full.*
Yes
I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*
Submit
We Support