Delisle Minor Ball

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2021 registration form

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

Postal Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Division:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

PAYMENT INFORMATION

Fees can be paid by: Etransfers can be sent to delisleminorballassociation@gmail.com and include the password in the message
Blastball $30
Parent pitch/mites $60
Squirt/Peewee/bantam $175
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I/we agree with the above *

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2021 registration form