Registration Form

Parent/Guardian 1:

P/G 1 Mobile #:

Parent/Guardian 2:

P/G 1 Mobile #:

Address:

Home #:

City:

       State:      Zip:

P/G 1 email:

Team Registration Only

P/G 2 email:

Showcase Team Tryout Registration

Player 1 Information:

Player 1 Name:

       Age:      Birth Date:

Select Camp(s):

        Current Little League:      School:

Preferred Positions:

   1st: First Base Second Base Third Base Short Stop Pitcher Catcher Outfield   2nd:  First Base Second Base Third Base Short Stop Pitcher Catcher Outfield   3rd:  First Base Second Base Third Base Short Stop Pitcher Catcher Outfield     Bats: Right Left Switch   Throws: Right Left

Physical Disabilities/Alergies:

Player 2 Information:

Player 2 Name:

       Age:      Birth Date:

Select Camp(s):

        Current Little League:      School:

Preferred Positions:

 1st: First Base Second Base Third Base Short Stop Pitcher Catcher Outfield   2nd:  First Base Second Base Third Base Short Stop Pitcher Catcher Outfield   3rd:  First Base Second Base Third Base Short Stop Pitcher Catcher Outfield     Bats: Right Left Switch   Throws: Right Left

Physical Disabilities/Alergies:

Health Insurance Information:

Insurance Company:

Group/Policy #

Medical Release Authorization

 I authorize the physicians of local hospitals to treat the injury or illness for my son or daughter's welfare.  I also authorize the staff of HR's & K's Baseball Academy to act for me in an emergency for my son or daughter. I hereby waive and release HR's & K's Baseball Academy from any and all liability for any injuries or illnesses incurred going to camp from home, while at camp, or returning home from camp.

Complete Registration

Signature:

Date: