Manhattan Badgers Travel Baseball Association

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Badgers Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

Home Phone:

* Birthdate:

* Email:

* Gender:

Grade:

* Age level for 2016 season:

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:

Who referred You?:

WAIVER INFORMATION

I agree to hold harmless the Manhattan Badgers Baseball Association, LW Central, Manhattan Park District and all other affiliates and facilities pertaining to the Manhattan Badgers Baseball.

I/we agree with the above *

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Badgers Registration Form