Roseville Senior Softball C League - Jack Johnson (Team #1) - 10/26/2021

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, Earl 01-01-0001 (0) 612-840-4877 (H)
,
Emergency contact Name: Phone:
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Cramer, Larry 10-01-1944 (77) 612-817-7414 (H)
1928 Warbler Ln St Paul, MN 55119 lrcramer@comcast.net Hammond, Ind
Emergency contact Name: Phone:
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Frank, Greg 06-10-1950 (71) 763-755-5036 (H)
649 119th Ave NE Blaine, MN 55434 fran1gre@juno.com Mounds View
Emergency contact Name: Judy Frank Phone: 763-755-5086
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Fricke, John 01-16-1943 (78) 763-571-4840 (H)
1517 Thollhagen Dr Ne Fridley, MN 55421 fricke.john1@gmail.com Litchfield, MN
Emergency contact Name: Maggie Fricke Phone: 612-850-4044
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Gardner, Bill 06-13-1955 (66) 651-731-8765 (H)
2822 Leyland Tr Woodbury, MN 55125 wmtgardner@comcast.net Chicago, Ill
Emergency contact Name: Sarah Phone: 651-260-0527
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Johnson, Jack 04-26-1946 (75) 651-983-5114 (H)
N 6123 650Th St Beldenville, WI 54003 jackdiane14@yahoo.com Prescott, WI
Emergency contact Name: Diane Johnson Phone: 651-210-2226
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Kukielka, Mick 06-23-1947 (74) 612-374-2629 (H)
2105 Fremont Ave S Minneapolis, MN 55405 mkukielka@comcast.net Mpls Edison
Emergency contact Name: Kathy Kukielka Phone: 612-916-5087
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Lamusga, Don 03-11-1954 (67) 651-490-9041 (H)
4273 Westin Way Shoreview, MN 55126 donlamusga@gmail.com DeLaSalle
Emergency contact Name: Linda Lamusga Phone: 651-490-9041
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Neubauer, Bruce 07-17-1947 (74) 651-303-9938 (H)
4107 Preserve Pl White Bear Lake, MN 55110 sbneubauer@comcast.net W. Aurora, Ill
Emergency contact Name: Phone:
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Newman, Don 07-26-1953 (68) 612-840-0536 (H)
3090 Lexington Av N Roseville, MN 55113 dwn726@gmail.com Silver Bay, Mn
Emergency contact Name: Phone:
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Parsons, Butch 12-08-1945 (76) 651-484-7323 (H)
9 Sandpiper Ln North Oaks, MN 55127 wbparsons@comcast.net Alexander Ramsey
Emergency contact Name: Phone:
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Remington, John 11-06-1941 (80) 612-723-0961 (C)
6140 Doffing Ave #31 Inver Grove Heights, MN 55076 remin003@umn.edu Duluth Denfield
Emergency contact Name: Phone:
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Sepple, David 01-25-1948 (73) 763-560-3456 (H)
3733 77Th Ave N Brooklyn Park, MN 55443 davidwsepple@gmail.com Columbia Heights
Emergency contact Name: Sue Phone: 612-990-3808
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