MCLA Baseball Clinic Registration

Email address *

Parent or Guardian (s) *

Mailing Address- Please include Street, City, State, and Zip Code *

Home Phone Number *

Emergency Contact and Phone Number *

Participant (s) Name *

Participant (s) Age *

Any Health Related Issues?? *

Allergies Diabetes Asthma Other None

Tee Shirt Size *

If registered by January 28th ONLY

Youth M Youth L Adult S Adult M Adult L

* required field