Roseville Senior Softball D League - Dick Anderson (Team #1) - 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, Dick 12-08-1931 (90) 612-710-7634 (H) 612-788-9771 (H)
2513 Silver Lane NE St Anthony Village, MN 55421 dick@andersonsfurnitureandcarpet.com Mpls Edison
Emergency contact Name: Phone:
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Brunell, Herb 10-24-1937 (84) 651-779-0013 (H) 952-240-1055 (C)
6358 25th St N Oakdale, MN 55128 hrbrunell@yahoo.com Mechanic Arts
Emergency contact Name: Phone:
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Dockery, Ron 09-23-1949 (72) 651-773-8246 (H)
284 Wildridge Road Mahtomedi, MN 55115 rondock@aol.com Ford HS, Laurens, SC
Emergency contact Name: Phone:
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Falvey, Donna 02-07-1962 (59) 651-983-7023 (H)
9025 Juneau Drive Woodbury, MN 55125 djfalvey@msn.com Mounds View
Emergency contact Name: Phone:
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Fondow, Robin 05-26-1954 (67) 651-487-5214 (H) 651-226-8306 (C)
1890 Alta Vista Drive Roseville, Mn 55113 rfondow@gmail.com Green Bay, WI
Emergency contact Name: Phone:
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Goblirsch, Mike 03-31-1943 (78) 763-755-7962 (H)
12088 Evergreen St NW Coon Rapids, MN 55448 mgoblirs@yahoo.com Sleepy Eye, MN
Emergency contact Name: Phone:
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Jones, Bob 11-12-1944 (77) 651-776-2241 (H)
650 E Belmont Ln Maplewood, MN 55117 sljones@comcast.net Hill-Murray
Emergency contact Name: Sandy Phone: 651-247-8985
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Kelling, Duane 01-22-1951 (70) 612-801-7084 (H)
2088 Hartford Ave St. Paul, MN 55116 duanekelling@gmail.com Prairie du Chien, WI
Emergency contact Name: Karen B. Phone: 612-632-8307
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Korf, Rod 09-17-1949 (72) 612-889-5958 (H) 651-731-8538 (H)
23250 Cornell St. Stacy, MN 55079 rodssn678@yahoo.com Hill-Murray
Emergency contact Name: Phone:
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Lehner, Bob 10-21-1946 (75) 320-583-4732 (H)
813 Beland Ave Vadnais Heights, MN 55127 pr.boblehner@gmail.com Upsala, MN
Emergency contact Name: Phone:
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Riener, Dick 03-07-1938 (83) 651-426-8610 (H)
1799 4th St White Bear Lake, MN 55110 rriener@comcast.net Harding
Emergency contact Name: Phone:
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School, David 12-21-1942 (79) 651-261-7488 (H)
6826 24th Street N Oakdale, MN 55128 davehschool@hotmail.com Northfield, MN
Emergency contact Name: Phone:
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Switzer, Tom 05-09-1954 (67) 612-685-6065 (H)
13200 - 57th Ave N Plymouth, MN 55442 Mpls Edison
Emergency contact Name: Phone:
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Tschida, Bob 07-17-1936 (85) 651-699-1264 (H)
2285 Stewart Apt 2220 St Paul, MN 55116 bgtschida@gmail.com Cretin
Emergency contact Name: Phone:
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Udean, Tony 05-17-1946 (75) 612-275-1206 (H)
3888 Greeley Rd Pine City, MN 55063 toude6@aol.com Braham
Emergency contact Name: Phone:
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