Roseville Senior Softball D League - Clint Hallmark (Team #4) - 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, Warren 09-27-1953 (68) 651-638-9252 (C)
1449 Brenner Ave Roseville, MN 55113 wjanderson927@gmail.com Brady, W. St. Paul
Emergency contact Name: Lori Anderson Phone: 612-875-1495
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Bennett, Kim 08-01-1959 (62) 612-581-4735 (C)
217 Colleen Ave Shoreview , MN 55126 kimmer912@yahoo.com Mariner
Emergency contact Name: Kelsey Mundell Phone: 615-816-1968
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Carpenter, Ron 04-03-1933 (88) 651-429-5561 (H)
4309 Oakmede Ln White Bear Lake, MN 55110 gmcofwbl@aol.com Johnson
Emergency contact Name: Phone:
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Hallmark, Clint 01-01-1953 (68) 612-816-8544 (C) 651-653-9920 (H)
2540 Buffalo White Bear Lake, MN 55110 Johnson
Emergency contact Name: Phone:
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Josephson, Dave 03-16-1948 (73) 651-308-0326 (H)
3020 Rice St. D-34 St Paul, MN 55113 1948dave@live.com Harding
Emergency contact Name: Phone:
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Lovaas, Timm 08-04-1950 (71) 612-202-5304 (H)
2786 Quebec ct. Little Canada, MN 55117 talovaas@netscape.net Columbia Heights
Emergency contact Name: Phone:
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Moore, George 10-04-1935 (86) 715-553-2162 (C)
245 Hamilton Ave Amery, WI 54001 moreless@amerytel.net Greenwood, WI
Emergency contact Name: Phone:
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Paaso, Reino 10-31-1950 (71) 612-599-6513 (H)
1235 Yale Pl unit 201 Minneapolis, MN 55403 reinopaaso@me.com Duluth Central
Emergency contact Name: Phone:
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Polster, Chris 04-29-1950 (71) 612-325-1280 (C)
9787 Cavell Circle Bloomington, MN 55438 polster.chris@gmail.com Highland Park
Emergency contact Name: Allison Polster Phone:
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Schad, Mike 04-02-1957 (64) 651-983-1174 (H)
977 Lydia ave w. Roseville, MN 55113 mikeschad57@gmail.com Lake City, MN
Emergency contact Name: Dianu Zimmerman Phone: 651-253-7776
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Slavik, Tom 12-21-1946 (75) 651-343-3256 (H)
10088 - 199th w Lakeville, MN 55044 tlslavik1@gmail.com Harding
Emergency contact Name: Phone:
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Sundberg, Jim 06-24-1949 (72) 651-485-3341 (H)
1864 Summit Ln Mendota Heights, MN 55118 missysundberg@yahoo.com Cretin
Emergency contact Name: Phone:
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Watrin, Leo 09-09-1948 (73) 651-297-8655 (H)
740 South Smith Ave St Paul, MN 55106 DeLaSalle
Emergency contact Name: Kevin Watrin Phone: 651-696-3223
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