Mud Dog Baseball - (Chicago, IL) - powered by LeagueLineup.com

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PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Age Group Trying out For:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* Relationship to player:

* EMail:

* Home Phone:

* Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Relationship to player:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

* Policy #:

WAIVER INFORMATION

I/we agree with the above *

Once registered, you will be contacted to arrange a Private Try-Out

Mud Dog Baseball is a private organization and has no members. Mud Dog Baseball 2025/2026

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