Baseball Registration Form Instructions:

Complete the form fields below that apply.

Copy and paste this page information into a new email and send it to the following address:  pisgahbaseball@carolina.rr.com 

Please make sure you do this before you leave this page to make your payment so that we will have your registration information.

Last,  click on the following link:  https://cms.paypal.com/us/cgi-bin/?cmd=_render-content&content_ID=marketing_us/send_money  
This will take you to the Pay Pal website for you to send your payment.  You should put pisgahbaseball@carolina.rr.com as the "pay to email."

Complete the information below that applies.

Copy and paste into

Registration fee is     $50.00  for ages 9-12

                                    $45.00 for ages 5-8

plus a $5.00 discount for each additional child.

Player's 1's First  Name:
Player's 1's Last Name:

Player's 2's First  Name:
Player's 2's Last Name:

Player's Age(s) as of 5/1/10  (Player 1 Age)(Player 2 Age)
Shirt Size(s) (Player 1) Shirt Size (Player 2)

Date of Birth (Player 1):    (Player 2)

Mother and Father's Name:

Address:

City:  State:
Zip Code:

Email: 

Health Insurance Provider:

Attending Physician: 

Home Phone #
Work Phone #
Cell #

Are you affiliated with a church? If so, name of church?

If your child were to sustain injury, can we treat your child as medically necessary? Yes or No

I give my consent that my child (Player 1)

(Player 2)can participate in the spring baseball program at Pisgah Associate Reformed Church, Inc. for the 2010 season.  I understand that Pisgah ARP Church, Inc and volunteer personnel are not responsible or liable for injuries sustained while participating in the program at the church fields and game fields.  I also acknowledge that the information provide above is correct.

By checking the "I agree" box you are acknowledging agreement and understanding of the above statement and acknowledging that all of the information submitted in this form is true.

I Agree    

I disagree

Does your child have a friend/relative playing? Yes/No  If so Who?

Are you interested in coaching a team or being a Team Parent?  If so explain:

We will make every attempt to pair friends and relatives.

Display your Pride! Order Team Apparel

All proceeds collected from the sale of team apparel is used to offset the cost of Pisgah Youth Sports Ministry.

Adult Items to match your child's team:  Please put quantity in box next to item (ex. Sm  2 ).

Adult Items to match your childs team:  Please put quantity in box next to item.

$8.00 Team Hat   Quantity:  

$13 Child Short Sleeve T-Shirt:  Small, Med, Large, X-Large               
Select Size:  

Small       Quantity 
Medium Quantity   
Large       Quantity   
XLarge    Quantity

$16 Child Long Sleeve T-Shirt:   Small, Med, Large, X-Large, XLarge

Small       Quantity 
Medium Quantity    
Large       Quantity   
XLarge    Quantity

$18 Child Sweat Shirt:  Small, Med, Large, X-Large, XLarge

Small       Quantity 
Medium Quantity   
Large       Quantity   
XLarge    Quantity

$25 Child Hooded Sweat Shirt:  Small, Med, Large, X-Large, XLarge

Small       Quantity 
Medium Quantity   
Large       Quantity   
XLarge    Quantity

$15 Adult Short Sleeve T-Shirt:  Small, Med, Large, X-Large, XXLarge      
Select Size:  

Small       Quantity 
Medium Quantity   
Large       Quantity   
XLarge    Quantity

$18 Adult Long Sleeve T-Shirt:  Small, Med, Large, X-Large, XXLarge      
Select Size:  

Small       Quantity 
Medium Quantity   
Large       Quantity   
XLarge    Quantity

$20 Adult Sweat Shirt:  Small, Med, Large, X-Large, XXLarge      
Select Size:  

Small       Quantity 
Medium Quantity   
Large       Quantity   
XLarge    Quantity

$27 Adult Hooded Sweat Shirt:  Small, Med, Large, X-Large, XXLarge      
Select Size:  

Small      Quantity 
medium Quantity   
Large       Quantity   
XLarge    Quantity

Merchandise Total Cost: 

Child Registration Costs: 

$50.00  for ages 9-12; $45.00 for ages 5-8 plus a $5.00 discount for each additional child:  Registration Total : 

Grand Total - Merchandise Total plus Registration Total: