Player First and Last Name *

Address 1 *

Address 2

City *

Zip *

Gender * Female Male Non-binary Prefer not to answer

Preferred Pronouns

Player Birthday *

Age *

If birthday is during the season would you like it to be recognized by the announcer?

Player Primary Diagnosis *

Secondary Diagnosis

Please select all that apply in regards to player needs while at bat. *

While batting, player is: *

Any additional information for staff, coaches and/or volunteers to be aware of:

Are there any unsafe behaviors that may be exhibited during games?

If player is an Augmentative and Alternative Communication user, please check any that apply:

Please explain other if selected.

Song Title *

Artist Name *

NO Music Request

Returning or New Player? *

Please select the appropriate league - a description of each is noted above. *

If there is a specific team the player would prefer to be on, note that in the space below. Please be advised, this is not guaranteed and players will be divided so teams are as even as possible.

Parent/Guardian First and Last Name *

Phone Number *

Email Address *

First and Last Name

Email

Jersey Size * Youth Small Youth Medium Youth Large Small Medium Large XLarge 2X 3X 4X 5X

Requesting a new jersey: *

Requesting a new hat: *