Athlete Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Athlete Phone

(###)

###

####

Parent/Guardian Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Primary Position(s) Played (Check all that apply) *

P

C

1B

2B

3B

SS

OF

Secondary Position(s) Played (Check all that apply) *

P

C

1B

2B

3B

SS

OF

If you pitch, describe your role:

Starting Pitcher

Relief Pitcher

Closer

"Eat Innings" guy who "can pitch"