EmailMe Form - Henderson 13 & Under Sign Up

Checkbox *

Male

Female

Birthdate

MM / DD / YYYY

Age as of January 1, 2023 *

Grade (2022/2023) *

Age Division *

12 & Under

Child's Name *

First Last

First Parent/Guardian Name *

First Parent/Guardian Relationship to Child *

First Parent/Guardian Phone:

*

### - ### - ####

Second Parent/Guardian Name

Second Parent/Guardian Relationship to Child

Second Parent/Guardian Phone:

### - ### - ####

Mailing Address (Street and PO Box if Applicable) *

Street Address City State / Province / Region Postal / Zip Code

Main Contact Phone # *

### - ### - ####

Email *

Shirt Size: *

Volunteer

I am willing to sponsor a team ($100)

I am willing to be a head coach

I am willing to be an assistant coach

I am willing to umpire

I am willing to help with concessions

12 & Under ($30) *

$ Dollars

Sponsorship - optional ($100)

$ Dollars

Sponsor Name (if sponsoring a team)

As to be printed on tshirt

By typing your name in the space provided below, you are hereby giving permission for your child to participate in the Henderson Summer Ball and/or Teeball Program. You also understand there is no insurance available through the ball program, and you will furnish the appropriate insurance for your child if you feel it is necessary. You also assume responsibility for any injury which may occur to your child. *