Florida Half Century Amateur Softball Association
Replacement / Updated Card
10/31/2024
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First Name | Middle Name | Last Name |
Permanent Home Address |
City | County | State | Zip |
Telephone Number | Date of Birth | / | / |
Months residing in Florida: From | to |
Street Address in FL |
City | County | Zip |
Telephone number, if different from above |
Current FHC number | If not known, approximate year you got your card |
Lost original, same address above |
Moved to a new Area - new address is above |
old address |
Requesting to be Grandfathered to old area. Explanation for why you want to be grandfathered: |
I have not been on roster for any teams in new area |
I would like to be grandfathered in so I can continue to play with my current team: |
1. | Completed form |
2. | $25 replacement fee - Personal or Business Check / Money Order / Cashier's Check Payable to Florida Half Century ASA, Inc. |
3. | Copy of current Driver's License or proof of current residence. |
Date | Signature of Applicant |
Type or Print Legibly, mail this application, proof of address and fee to:
Mike Knowles
3806 30th Lane E.
Bradenton, Fl 34208
Call 941 725-0790, if questions
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ALERT -- ALERT -- ALERT
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