Waiver: I do hereby agree to release the cities of Roseville, Little Canada, Stillwater and Blaine as well as the counties of Anoka, Ramsey and Washington and the Roseville Senior Softball Association, its Officers, Directors, Managers and Players from any liability, claim, injury, or damage of whatever kind or nature resulting from my participation in the game of softball. I further understand that there is always a risk in group activities of contracting viruses or other illnesses and my release is inclusive of such. I give my permission for the rendering of any necessary emergency medical treatment whatsoever which may have to be rendered due to my participation in this activity.
| Name / DOB / Address | Phone / Email | Paid / High School | Signature | |
|---|---|---|---|---|
| Filipek, Tom | 07-25-1963 (58) | 612-840-6653 (H) | ||
| 13555 Freeland Av Hugo, MN 55038 | t.filipek@comcast.net | Alexander Ramsey | ||
| Emergency contact | Name: Karen Filipek | Phone: 612-816-6462 | ||
| . | ||||
| Johnson, Lee | 07-16-1946 (75) | 612-810-7676 (H) | ||
| 9244 Neal Ave N. Stillwater, MN 55082 | makita100@comcast.net | Johnson | ||
| Emergency contact | Name: Sue Haigh | Phone: 651-283-1498 | ||
| . | ||||
| Kinsella, Tim | 06-13-1954 (67) | 605-310-3542 (C) | ||
| 4023 Hadley Ave N Oakdale, MN 55128 | timpk13@q.com | Estherville High | ||
| Emergency contact | Name: Jane | Phone: 605-310-3541 | ||
| . | ||||
| Koenig, Jim | 09-03-1954 (67) | 651-343-6326 (C) 651-777-0743 (H) | ||
| 4167 Goodwin Av Oakdale, | jkoenig3m@aol.com | Cretin | ||
| Emergency contact | Name: Burt, Briana | Phone: 651-343-6325 | ||
| . | ||||
| Lundin, Dave | 06-08-1956 (65) | 651-395-1451 (H) | ||
| 3440 Leyland Trail Woodbury, MN | djlundin@hotmail.com | Johnson | ||
| Emergency contact | Name: Kathy Lundin | Phone: 612-209-5823 | ||
| . | ||||
| Rutherford, Mark | 04-11-1958 (63) | 651-226-4116 (C) 6514831643 (H) | ||
| 1168 Fernwood Ct Shoreview, MN 55126 | ruthe003@umn.edu | Wheaton, Ill | ||
| Emergency contact | Name: Mary Rutherford | Phone: 612-414-4176 | ||
| . | ||||
| Sanny, John | 06-14-1954 (67) | 651-726-4701 (C) | ||
| 3506 Nancy pl Shoreview, MN 55126 | jd.sanny@gmail.com | Johnson | ||
| Emergency contact | Name: Diane | Phone: 651-734-3455 | ||
| . | ||||
| Satrom, Donn | 12-12-1946 (75) | 651-483-4810 (H) 651-587-9798 (C) | ||
| 2459 Matilda Cr Roseville, MN 55113 | dlsatrom@comcast.net | Grand Forks, ND | ||
| Emergency contact | Name: Linda Satrom | Phone: 651-900-3508 | ||
| . | ||||
| Scherek, John | 06-27-1950 (71) | 651-429-5521 (H) 651-206-2357 (C) | ||
| 2775 S Riviera Dr White Bear Lake, MN 55110 | jscherek627@hotmail.com | North St. Paul | ||
| Emergency contact | Name: Linda Scherek | Phone: 651-429-5521 | ||
| . | ||||
| Swanson, Wayne | 07-12-1956 (65) | 651-295-2685 (H) | ||
| 26 eagle ridge rd north oaks, mn 55127 | waynevswanson@hotmail.com | Simley | ||
| Emergency contact | Name: Holly Swanson | Phone: 651-295-3363 | ||
| . | ||||
| Zicopula, Jim | 01-24-1949 (72) | 651-483-9809 (H) | ||
| 166 Woodridge Ln Lino Lakes, MN 55014 | zposter@aol.com | Elmhurst, NY | ||
| Emergency contact | Name: Chris | Phone: 612-597-4705 | ||
| . | ||||