CENTRAL OHIO SENIOR SOFTBALL ASSOCIATION

REGISTRATION FORM (65+, 70+, 75+ LEAGUES)- 2024 SEASON
INSTRUCTIONS:

PLEASE COMPLETE THE ENTIRE FORM AND SIGN AT THE BOTTOM.
YOU MAY FILL IN THE BLANK SPACES (EXCEPT SIGNATURE AND DATE) BEFORE YOU PRINT THE FORM.
DO NOT SEND CASH. MAKE YOUR CHECK OR MONEY ORDER PAYABLE TO THE COSSA
COMPLETED APPLICATIONS AND REGISTRATION FEES ARE DUE NO LATER THAN APRIL 15, 2024
ONE FORM IS USED FOR ALL LEAGUES. MAIL YOUR APPLICATION AND PAYMENT TO THE COSSA TREASURER: 
RICH MARTORANO, 9873 MORRIS DRIVE, DUBLIN, OH 43017
PLAYER INFORMATION (PLEASE PRINT)
Last Name:   First name: Date of Birth: (MM/DD/YYYY) 

Address:   City: Zip: 

Email:  Preferred Phone: Alternate Phone: 

Emergency Contact:   Relationship: Emergency Contact Phone: 



Applying for the following Divisions (Leagues)-Mark Each.

65+ League: Fee: ($60)Fee: $ New to League (Y/N): 
70+ League: Fee: ($60)Fee: $ New to League (Y/N): 
75+ League: Fee: ($50)Fee: $ New to League (Y/N): 

Enter the Total Fees Being Paid: $ 

Willing to Manage a Team: (Y/N)

WAIVER:
I Full Name:  hereby agree to participate in the softball program offered by the Central Ohio
Senior Softball Association (COSSA), acknowledge that participatation in this program may involve risk of physical
injury due to the game's activity. In consideration of acceptance in this program, I hereby release and forever
discharge for myself, heirs, executers and administrators from any and all claims to collect damages and promise
not  to sue COSSA, its Board, its Team Manager(s), and any municipalities that may host the COSSA and their
representatives, agents, officials, directors, sponsors, insurers and any other individual activity with this program.

I hereby further agree to indemnify and hold harmless the COSSA and any other participating municipalities that may
host league games and activities harmless from and against any and all action, cause of action, claims, charges,
demands, complaints, damages, injuries, costs, loss of services, expenses, compensation and insurer claims arising
out of or account of or resulting from my participation in this said softball program. I further represent that I am
in good physical condition and can safely participate in this Competitive Softball League Team Sport program.



Signature: ___________________________________  Date: ___________________