2023 Registration Form (North Middlesex Baseball)

Print 2023 Registration Form

PLAYER TO BE REGISTERED

Date of Birth:^*

DIVISION REGISTERING FOR

Please select the division you are registering you child for. Please observe date of birth for the respective division.

What division is your child?^*

Pick from the list, division your child based on age?

PARENT/GUARDIAN INFORMATION

This section to be completed by parent or guardian

Parent/Guardian Last Name^*
Parent/Guardian First Name^*
Telephone Res:^*

Example: ###-###-####
Telephone Other:

Example: ###-###-#### x###
Email:^*

All correspondence will be sent to this email address
Parent/Guardian Home Address
Same as Player (if same as player you do not need to fill in the address information below)
Street Address.:
Unit No.:
City
Postal Code:

PLAYER EMERGENCY CONTACT

Volunteer Coaching or Assist Coaching

Please indicate if you would like to help coach or coach a team? If not, enter "No"

E Transfer Notification

The following will be the default Security Question and Answer for E transferring registration fee. This will eliminate any errors with payment.

Payment

An family rate of $350 will apply for 3 or more players. No refunds after June 1, 2023.

Payment^*

Once you have completed and submitted all applicable information, payment is to be through either email payment, or cheque payable to NMMBA.

Human Validation