VERIFICATION
Parent or Legal Guardian Agreement: By my signature below, I certify that all the information provided for this Tour nament Player Verification is tr ue and correct and provides the necessary
documentation required by Little League to verify league/tournament age and residence/school attendance eligibility. If the Charter/Tournament Committee subsequently finds that the
information submitted as acceptable documentation regarding league/tournament age and residence eligibility now shows that the previously submitted information/documentation
was falsified, misrepresented or insufficient then Little League Baseball
®
, Incorporated reserves the right to impose sanctions and/or penalties on all appropriate parties, including but
not limited to players, coaches, tournament teams, league officials and/or the league which could result in suspension and/or terminations with Little League Baseball, Incorporated.
_________________________________________________________________________________________________________________________________________
Name (Printed) of Parent/Legal Guardian Signature of Parent/Legal Guardian Date
League President’s Verification: I have reviewed and verified that the information presented here is true and correct and provides the necessary documentation required by
Little League to verify league/tournament age and residence/school attendance eligibility. If the Charter/Tournament Committee subsequently finds that the information submitted
as acceptable documentation regarding league/tournament age and residence eligibility now shows that the previously submitted information/documentation was falsified,
misrepresented or insufficient then Little League Baseball, Incorporated reserves the right to impose sanctions and/or penalties on all appropriate parties, including but not
limited to players, coaches, tournament teams, league officials and/or the league which could result in suspensions and/or terminations with Little League Baseball, Incorporated.
_________________________________________________________________________________________________________________________________________
Name (Printed) of League President Signature of League President Date
District Administrator’s Review: I have reviewed the residency documentation and players’ original birth certificate, and the information presented here, to the best of my
knowledge, appears to be acceptable under Little League standards and guidelines.
_________________________________________________________________________________________________________________________________________
Name (Print) of District Administrator Signature of District Administrator Date
NOTE: This form and attached original documentation 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.
Last Updated: 12/2/2016
LITTLE LEAGUE
®
BASEBALL AND SOFTBALL
TOURNAMENT PLAYER VERIFICATION
Date Requested ___________________________ (
check one
) BASEBALL SOFTBALL
League Name ________________________________________________ League ID# ______________________
PLAYER INFORMATION AND DOCUMENTATION
Player Name _______________________________________________________________________ Date of Birth ___________
(must be name as shown on the birth documentation)
TYPE OF AGE PROOF: (CHOOSE ONE)
□ Board of Health/Registrar of Vital Statistics □ Federal/Military □ In-Lieu Statement (necessary document from all four groups)
RESIDENCY PROOF: (CHOOSE ONE OR MORE DOCUMENTS FROM EACH OF THE THREE GROUPS)
ADDRESS OF PARENT OR LEGAL GUARDIAN
Street Address __________________________ City ____________________ State ______________ Zip ___________
GROUP ONE
FF Driver’s License
FF School Records
FF Vehicle Records (i.e., registration, lease, etc.)
FF Employment Records
FF Insurance Documents
GROUP TWO
FF Welfare/Child Care Records
FF Federal Records (i.e., Federal Tax, Social
Security, etc.)
FF State Records
FF Local (Municipal) Records
FF Support Payment Records
FF Homeowner/Tenant Records
FF Military Records
GROUP THREE
FF Voter’s Registration
FF Utility Bills (i.e., gas, electric, water/sewer,
phone, mobile phone, heating, waste disposal)
FF Financial Records (i.e., loan, credit,
investments, etc.)
FF Medical Records
FF Internet, Cable, or Satellite Records
- OR -
SCHOOL ENROLLMENT PROOF: (CHOOSE ONE)
FF Official/Certified school enrollment record dated prior to October 1 of current academic year
FF A Little League issued school attendance form completed by the school administrator, principal, or vice principal
SCHOOL ADDRESS
Street Address __________________________ City ____________________ State ______________ Zip ___________
Existing Waiver (if applicable): II(d) Waiver □ IV(h) Waiver □ Charter Committee Waiver
All residency documentation must be attached to this form
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