Roseville Senior Softball CD League - Dave Sundmark (Team #6) - 7/6/2022

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 / Age / Address Phone / Email Paid / High School Signature
Arnold, Steve 70 612-202-0948 (C)
10714 Buchanan St Blaine, MN 55434 wmsarnold@msn.com NW - Delohi MD
Emergency contact Name: Phone:
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Brown'Pena, Luis 72 651-442-0956 (C)
965 Smith Ave S West St. Paul, MN 55118 lbrownpena@yahoo.com Nicaragua
Emergency contact Name: Maria Victoria Brown'Pena Phone: 612-414-1585
.
Dockery, Ron 73 651-773-8246 (H)
284 Wildridge Road Mahtomedi, MN 55115 rdockery512@gmail.com Ford HS, Laurens, SC
Emergency contact Name: Susan Dockery Phone: 651 206-9482
.
Forys, Lance 72 651-271-2348 (H)
1365 Whistler Pt Rd Woodbury, MN 55129 l.forys@hotmail.com Johnson
Emergency contact Name: Jan Phone: 651-739-9508
.
Funkenbusch, Arnie 72 612-297-8469 (C)
1040 Hallam Ave N Mahtomedi, MN 55115 afunkenbusch@msn.com Houghton
Emergency contact Name: Diane Furlong Phone: 651-260-3942
.
Goin, Mark 71 651-278-1881 (H) 651-428-8623 (C)
19109 Cottage Rd Farmington, MN 55024 mwagoin@comcast.net Kennedy
Emergency contact Name: Liz Phone: 651-428-8623
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Hall, Vernon 75 651-210-2179 (H)
1976 Rishworth Lane White Bear Lake, MN 55110 vernjhall@gmail.com Mounds View
Emergency contact Name: Phone:
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Hurry, David 72 651 442-6611 (C)
14565 109th St Ct N Stillwater, MN 55082 dlhurry@msn.com
Emergency contact Name: Denise Hurry Phone: 612 202-5757
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Kukielka, Mick 75 612-374-2629 (H)
2105 Fremont Ave S Minneapolis, MN 55405 mickkukielka1@gmail.com Mpls Edison
Emergency contact Name: Kathy Kukielka Phone: 612-916-5087
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Ritter, Dick 85 540 359-2315 (H)
10521 Golden Eagle Tr Woodbury, MN 55129 dick_ritter@yahoo.com Prairie Farm, WI
Emergency contact Name: Phone:
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Severson, Dale 87 651-483-0766 (H)
20 E Gilfillan Rd St Paul, MN 55127 sfseverson@gmail.com Eau Claire, WI
Emergency contact Name: Sharon Phone: 651-895-6565
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Sundmark, Dave 72 651-735-0386 (H) 651-261-4440 (C)
2206 Marillac Ln St Paul, MN 55119 djsundmark@comcast.net Harding
Emergency contact Name: Lynn Sundmark Phone: 651-735-0386
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Swanson, Glenn 79 651-430-2267 (H)
10258 119th St N Stillwater, MN 55082 Harding
Emergency contact Name: Phone:
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Zicopula, Jim 73 651-483-9809 (H)
166 Woodridge Ln Lino Lakes, MN 55014 zposter@aol.com Elmhurst, NY
Emergency contact Name: Chris Phone: 612-597-4705
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