Roseville Senior Softball D League - Mike Fitzgerald (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
Alles, Don 11-05-1954 (67) 269-209-0741 (C)
1321 County Road C2 West Roseville, MN 55113 donalles@gmail.com Lakeview, MI
Emergency contact Name: Phone:
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Bonniwell, Dave 11-07-1944 (77) 651-457-9208 (H)
4582 Bloomberg Ln Inver Grove Heights, MN 55076 bwell@live.com St Agnes
Emergency contact Name: Phone:
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Bradbury, John 09-13-1947 (74) 612-443-7488 (H)
732 Parkside Drive Vadnais Heights, MN 55127 jjcbradbury@yahoo.com Newark, NJ
Emergency contact Name: Phone:
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Brown'Pena, Luis 06-22-1950 (71) 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
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Dahl, Jim 06-27-1942 (79) 651-592-6511 (C)
1461 Pine Tree Lane Houlton, WI 54082 jim@dahl-house.us Madison, WI
Emergency contact Name: Phone:
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Fitzgerald, Mike 06-06-1943 (78) 651-489-0562 (H)
961 W California Ave St. Paul, MN 55117 mfitz27@yahoo.com St Agnes
Emergency contact Name: Yvonne Fitzgerald Phone: 651-489-0562
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Frisco, Jerry 04-04-1938 (83) 612-781-1915 (H)
1818 Ulysses St. NE Minneapolis, MN 55418 Dilworth, MN
Emergency contact Name: Phone:
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Gratzek, John 12-27-1939 (82) 952-607-7333 (H)
15001 Burnhaven Dr #121 Burnsville, MN 55306 grat99zek@yahoo.com Steven, MN
Emergency contact Name: Phone:
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Hiber, Ed 07-14-1940 (81) 651-489-0513 (H)
1454 Alameda St St Paul, MN 55117 edhiber@yahoo.com St Agnes
Emergency contact Name: Phone:
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Hirsch, Deb 06-05-1956 (65) 651-459-4336 (C)
395 16th Street Newport, MN 55055 softballdebs@gmail.com Cretin
Emergency contact Name: Barb Hirsch Phone: 651-457-1697
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Junkermeier, Larry 01-20-1938 (83) 651-777-5801 (H)
3476 Rolling View Ct White Bear Lake, MN 55110 ljunkermeier@yahoo.com Atwater
Emergency contact Name: Lynne Phone: 651-777-5801
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McGowan, Jim 07-30-1936 (85) 651-641-1217 (H)
1181 Edgcumbe Rd, Unit 1111 St Paul, MN 55105 lotsajim@comcast.net Mechanic Arts
Emergency contact Name: Phone:
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Miller, Bob 12-27-1939 (82) 651-430-8186 (H)
3673 Tending Green Stillwater, MN 55082 Johnson
Emergency contact Name: Phone:
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Novotny, Tom 10-14-1936 (85) 651-483-1643 (H)
5515 Turtle Lk Rd Shoreview, MN 55126 banovotny@aol.com St Agnes
Emergency contact Name: Phone:
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Stoerzinger, Jerry 04-19-1945 (76) 651-770-2530 (H)
7689 64th St Pine Springs, MN 55115 jerry.stoerzinger@hotmail.com Johnson
Emergency contact Name: Phone:
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