Initial Registration | NJ Rising Rebels

INITIAL
REGISTRATION FORM

PLAYER INFORMATION

FULL NAME:

HIGH SCHOOL:

GRADE:

DATE OF BIRTH:

STUDENT CELL PHONE:

HOME NUMBER:

STUDENT EMAIL:

HOME ADDRESS:

PARENT NAMES:

PARENT EMAIL 1:

PARENT EMAIL 2:

BASEBALL INFORMATION

PRIMARY POSITION:

SECONDARY POSITION:

BAT (L/R):

THROW (L/R):

HEIGHT:

WEIGHT: (LBS)

PREVIOUS INJURIES:

APPROX PREV INJURY DATE:

CURRENT INJURIES:

APPROX CURRENT INJURY DATE:

HOW DID YOU HEAR ABOUT US?:

SECURITY: