Team New Jersey Softball Recruiting Clinic

REGISTRATION FORM
Wednesday, June 22, 2011 - 9:00 AM 1:30 PM - Pennsbury Softball Complex Yardley, PA
PERSONAL INFORMATION Your Name: Date of Birth: Home Phone: Home Address: City: Womans Shirt Size: S M XXL L XL State: Zip: Height: Email: Cell Phone:

SOFTBALL INFORMATION Primary Position Bats

(circle one): (circle position you will play at Clinic):

P C LF R

1B L

2B

3B

SS

RF

CF

L SW SLAP

Throws: Club Team Name: Coach Cell:

Club Coach Name: Coach Phone: Academic Information High School: GPA: SAT Score: / 4.0 Class Rank: ACT Score:

Grad Year: College Major:

2012

2013

2014

I, the parent/legal guardian of the student-athlete registered herein, grant permission and authorization for statistics, data, testing results, personal information, photographs, audio and video materials related to this Clinic to be released (and possibly posted electronically) to coaches, scouting organizations, media outlets, team physicians, athletic trainers, partner entities, administrative personnel and possibly the general public. I also understand that the data, information, photographs, audio and video materials are and will remain property of ESPN Wide World of Sports and/or Team New Jersey Softball. Parent/Guardian Signature ________________________________________________ Date _______________ Emergency phone number, if needed: _____________________________ Make sure you enclose a CHECK for $150 made payable to Team New Jersey Softball and mail with this form to: Team New Jersey Softball PO Box 266 Lincroft, NJ 07738