Miracle League of Northampton County Player Registration
* Required
Players First Name:
*
Your answer
Player's Last Name:
*
Your answer
Male or Female?
*
Male
Female
Date of Birth (mo/day/year
*
Your answer
Current Age:
*
Your answer
Parent / Guardian First Name:
*
Your answer
Parent / Guardian Last Name:
*
Your answer
Home Phone Number:
*
Your answer
Email Address:
*
Your answer
Street Address:
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Your answer
City:
*
Your answer
State:
*
Your answer
Zip Code:
*
Your answer
Municipality Living In (City, Borough, Township)
*
Your answer
Disability:
*
Your answer
Any Special Needs or Requirements?
Your answer
If Player was on a Team last season, what was the team?
Yankees
Tigers
Mets
Red Sox
Orioles
Dodgers
Cubs
Cardinals
Phillies
Pirates
Shirt Size:
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X Large
Adult XX Large
Sign me up for the automated phone system to receive league announcements and news
Yes
No
Sign me up for the league newsletter
Yes
No
I'd like to join the Booster Club
Yes
No
Have you read the Release document on the Registration Page on the Web Site?
*
Your child will not be able to participate in the MLNC program unless you have read and agreed to what is stated in the Release.
http://miracleleagueofnc.org/player-release
Yes
No
Do you agree with what is stated in the Release Document
*
Yes
No
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