WHAT TO SEND CHECKLIST
FIRST TIME APPLICATIONS MUST INCLUDE
1Player Registration Form
2Registration Fee
3Copy of Photo ID, such as valid Drivers License, Passport, Military ID
4
Copy of second form of ID with name and date of birth, such as Birth
Certificate, Armed Forces Discharge, etc. (Sending Driver's
License and Passport or Military ID is acceptable)
5Clear color photo (No black and white or faxed photos, please)
RENEWALS MUST INCLUDE
1
Player Registration Form
2
Registration Fee
3
Clear color photo (No black and white or faxed photos, please)
4
OR, you may call the office and renew over the phone with a credit card
FEE SCHEDULE - CHECK ONE
(YEARS TO NEXT 5-YEAR AGE GROUP)
$30 = One Season / Age 75+
$40 = Two Seasons
$50 = Three Seasons
$60 = Four Seasons
$65 = Five Seasons
Player Registration Form
Senior Softball National Identification Card
For the Senior Softball Tournament Season
NOTICE: Subscription to Senior Softball News included! (except Canada - Call SSUSA for rates)
FIRST TIME RENEWAL
REGISTRATION
REPLACEMENT
($30 FEE)
NEW REGION
($30 FEE)
PLEASE TYPE OR PRINT LEGIBLY SSUSA CARD NUMBER, IF ANY
NAME NICKNAME
STREET ADDRESS
CITY STATE ZIP CELL
DATE OF BIRTH E-MAIL
AGE GROUP TEAM AFFILIATION
EMERGENCY CONTACT PHONE
I hereby certify that the information provided is correct and further agree that it may be verified. Any
falsification of information will result in disciplinary action including suspension or banishment from Senior
Softball USA sanctioned tournaments. I understand that on site, this ID card may be required as proof of
identity before I am permitted to participate in any Senior Softball USA sanctioned tournament.
_______________________________________
APPLICANT SIGNATURE
This completed form must be received 20 days prior to the Tournament you wish to enter
Make 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: register@seniorsoftball.com
Use "Tab" key to move between data entry fields - When completed, print the form and deliver, mail or fax to Senior Softball USA
Clear Form
Print Form
2021
• NOTE: 4% fee for CC using Visa, Mastercard or Discover
• NOTE: 4% fee for CC using Visa, Mastercard or Discover
11/19/2020 10:00