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  PLEASE FILL OUT IN FULL AND HIT SUBMIT.  IF YOU DO NOT RECEIVE A CONFIRMATION PAGE PLEASE CALL   JARED AT (631) 656 - 3087

 

Name         

Address      

City            

State          

Zip               

Email         

Phone #     

 Age           

 DOB             

 

Hitting Rating (From 1-10 10= Best)

Average        

Power           

Speed            

Fielding Rating (From 1-10 10 = Best) 

Positions Played (hold down CTRL key and click on all that apply)