Garden State Rebels Registration FormGarden State Rebels Registration FormPlayers Name *FirstLastCheck OneMaleFemaleAddress:Date of Birth:Age:E-mail *Players Cellphone:Current School/High School:Players Email:HS Graduation Year:Current Grade:HS Graduation Year: (copy) (copy)Mothers Name: *FirstLastMothers Email: Mothers Cellphone:Mothers Address: (Enter Same if Same as Players)Fathers Name: *FirstLastFathers Email:Fathers Cellphone:Fathers Address: (Enter Same if Same as Players)Has this Player Played for a Travel or Club Team Before? (Check One)YesNoIf Yes Please List Name(s) of Organization(s):Primary Position:Secondary Position:Tertiary Position:Batting: (Check One)RightLeftBothThrowing: (Check One) RightLeftBothPitcher: (Check One)RightLeftBothPitches: (Check One)RightLeftBothLast Clocked Pitch Speed: (MPH)Emergency Contact Name:Emergency Contact Phone#:Relationship to Player:Insurance Carrier:Insurance Policy#:Please attach a copy of participation waiver form to Registration Form and submit with the non-refundable registration fee of $20. Medical clearance forms and physicals may be requested by The Garden State Rebels management.Parents Name:Date:Players (age 18) Name:DateSubmit
