Roseville Senior Softball B League - Bob Broberg (Team #3) - 5/9/2021

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
Anderson, Jerry 01-10-1950 (71) 651-770-8791 (H)
3649 Grovner Rd N Oakdale, MN 55128 andersonjd@comcast.net Kellogg
Emergency contact Name: Joanne Phone: 651-770-8791
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Broberg, Bob 02-05-1948 (73) 651-785-7943 (C) 651-699-5269 (H)
1240 Colette Pl St Paul, MN 55116 bobbroberg@icloud.com St Agnes
Emergency contact Name: Nancy Broberg Phone: 651-785-7928
.
Christiansen, Kim 03-17-1954 (67) 612-263-3798 (C)
3396 120th Circle NE Blaine, MN 55449 kimchristiansen1@gmail.com New Salem, ND
Emergency contact Name: Doris Christiansen Phone: 701-426-9357
.
Cook, Mike 01-24-1948 (73) 651-735-8934 (H) 651-253-8549 (C)
2532 Nokomis Ave. St. Paul, MN 55119 majcook92@comcast.net Monroe
Emergency contact Name: Joan Phone: 651-735-8935
.
Donnelly, Mike 01-06-1952 (69) 651-303-8295 (C)
130 Wheeler St. S St. Paul, MN 55105 mjdonnelly4@yahoo.com Cretin
Emergency contact Name: Deb Donnelly Phone: 651-271-3700
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Heinz, Mark 06-26-1945 (76) 954-249-4032 (C)
4420 Cumberland Ct Shoreview, MN 55126 mark_heinz@msn.com St. Thomas Academy
Emergency contact Name: Phone:
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Henjum, Keith 04-22-1953 (68) 651-334-9910 (H) 651-730-0499 (H)
1417 Cedarwood Dr Woodbury, MN 55125 keithhenjum@comcast.net Richfield
Emergency contact Name: Barb Henjum Phone: 651-263-8818
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Holm, Jerry 06-01-1948 (73) 763-381-1859 (H)
6098 Merles Ln NW Anoka, MN 55013 jerryholm@centurylink.net Robbinsdale
Emergency contact Name: Sue Holm Phone: 651-252-5057
.
Kennedy, Bruce 04-27-1952 (69) 651-633-3713 (H)
1416 Skillman Av W Roseville, MN 55113 brucekennedy@brucekennedylaw.com Chicago, Ill
Emergency contact Name: Linda Kennedy Phone: 651-295-3907
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Maul, Marlin 07-10-1948 (73) 651-303-5335 (C)
3419 Commonwealth Ave. Woodbury, MN 55125 marlinmaul@msn.com St. Paul Central
Emergency contact Name: Shirley Maul Phone: 651-303-4457
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Steiner, Les 06-25-1947 (74) 651-208-2078 (H)
2690 Oxford St N #215 Roseville, MN 55113 lgstein@yahoo.com Crookston, MN
Emergency contact Name: Phone:
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Wicklander, Rudy 10-03-1947 (74) 612-961-5139 (H)
6587 145th Circle N Hugo, MN 55038 rudy@rowbuilders.com Roseau
Emergency contact Name: Judy Wicklander Phone: 612-865-2909
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Wicklander, Randy 11-05-1953 (68) 612-719-3835 (C)
7987 Griffith Av NW Maple Lake, MN 55358 randy_wicklander@yahoo.com Roseau
Emergency contact Name: Phone:
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Wind, Al 01-18-1952 (69) 651-463-6788 (H) 612-296-1406 (C)
177 Hickory Ct Farmington, MN 55024 summer57@frontiernet.net Cretin
Emergency contact Name: Phone:
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