Initial Contact | NJ Rising Rebels

INITIAL
CONTACT FORM

To Get Started, Please Fill Out The Entire Application and Submit.
Our Team Will Review Your Application and Will Contact You Shortly.

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: (FT / IN)

WEIGHT: (LBS)

PREVIOUS INJURIES:

APPROX PREV INJURY DATE:

CURRENT INJURIES:

APPROX CURRENT INJURY DATE:

HOW DID YOU HEAR ABOUT US?:

SECURITY:

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