Roseville Senior Softball C League - Will Carlson (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
Bahns, Tom 12-14-1951 (70) 651-249-9295 (H)
110 Park Ave Milaca Mn, MN 56353 bahns451@yahoo.com Pierz, MN
Emergency contact Name: Phone:
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Borner, Gordy 01-22-1950 (71) 715-307-0653 (C)
W6575 630rd Ave Beldenville, WI 54003 gordonbornerrealty@gmail.com Park Cottage Grove
Emergency contact Name: Julie Borner Phone: 715-307-1767
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Brown, Bob 01-01-1952 (69) 612-840-7961 (H)
7931 Claiborne Lane Inver Grove Heights, MN 55076 Simley
Emergency contact Name: Phone:
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Carlson, Will 01-21-1943 (78) 651-247-5702 (H)
488 Atwater Circle St Paul, MN 55103 will@customdrywall.net Washington
Emergency contact Name: Phone:
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DeYoung, Jim 06-04-1953 (68) 763-434-8115 (H) 763-614-8986 (H)
14715 Harpers St Ham Lake, MN 55304 jdeyoung1@q.com Highland Park
Emergency contact Name: Phone:
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DeYoung, Jenny 09-15-1962 (59) 763-434-8115 (H)
14715 Harpers Street NE Ham Lake, Mn 55304 jdeyoung1@q.com Hinckley
Emergency contact Name: Jim DeYoung Phone: 763-434-8115
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Erdman, Jim 05-23-1946 (75) 651-592-8214 (H)
4735 Cumberland St Shoreview, MN 55126 jimerdman12@yahoo.com Menomonee Falls, WI
Emergency contact Name: Diane Phone: 612-600-6205
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Furry, Rich 06-27-1958 (63) 612-221-4991 (H)
6925 Arlene Ave. Inver Grove Heights, MN 55077 rich@customdrywall.net Mpls South
Emergency contact Name: Phone:
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Hanson, Steve 07-15-1954 (67) 612-919-1824 (C)
592 Sibley Ct Mendota Heights, MN 55118 stevehanson@customdrywall.net
Emergency contact Name: Jackie Hanson Phone: 651-353-3113
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Hanson, Russ 03-11-1958 (63) 612-919-1820 (C)
6147 Parkridge Dr White Bear Lake, MN 55110 russhanson@costomdrywall.net
Emergency contact Name: Sue Hanson Phone: 612-501-4659
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Hughes, Jack 02-03-1950 (71) 651-263-9740 (C) 651-748-1432 (H)
, jr.hughes9740@gmail.com Alexander Ramsey
Emergency contact Name: Char Hughes Phone: 612-432-5349
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Johnson, Bob 06-13-1946 (75) 651-777-6578 (H) 651-442-4315 (H)
2850 Hamlet Ave N Oakdale, MN 55128 North St. Paul
Emergency contact Name: Phone:
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Krieglmeier, Greg 08-04-1964 (57) 612-369-7707 (C)
1865 45th Street Somerset, WI 54025 gregkrieglmeier@customdrywall.net
Emergency contact Name: Peggy Krieglmeier Phone: 651-283-1419
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Nelson, Wayne 06-17-1947 (74) 651-246-4850 (H)
1995 Duluth St Maplewood, MN 55109 wnelson1995@gmail.com Johnson
Emergency contact Name: Phone:
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Shipp, Sandy 02-17-1966 (55) 612-242-5538 (C)
1714 Buchannon St NE Minneapolis, MN 55413 sandyshipp@outlook.com Central, NY
Emergency contact Name: Phone:
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