PLAYER INFORMATION

PLAYER NAME:

GENDER:             MALE                  FEMALE

DATE OF BIRTH:

HOME PHONE NUMBER:

STREET ADDRESS:

CITY:          
COUNTY:     
PROVINCE:  
POSTAL CODE:

SCHOOL:

DIAGNOSIS:

SPECIAL NEEDS:

REGISTER FOR:  (Season 1 May-Jun)   (Season 2 Sept-Oct)

PLAYER'S SHIRT SIZE:
Youth size:    S    M    L    XL
Adult size:    S    M    L    XL    XXL

FAVOURITE COLOUR:

FAVOURITE FOOD:

FAVOURITE MOVIE / TV:
 

FAVOURITE SONG:
     

PARENT INFORMATION

PARENT/GUARDIAN FULL NAME:

WORK OR CONTACT NUMBER:

EMAIL ADDRESS:

I WILL ALSO VOLUNTEER FOR (check all that apply)

   ACTIVITY COMMITTEE
  CONCESSION STAND
   TEAM PARENT
  GAME ANNOUNCER
   COACHING
  SCOREBOARD OPERATIOR / SOUND OPERATOR

SPONSORSHIP FUNDS ARE AVAILABLE TO ANY PLAYER. PLEASE CONTACT THE AMHERSTBURG MIRACLE LEAGUE REGISTRATION DIRECTOR, ANN BONDY AT annbondy@amherstburgmiracle.com,

OR TELEPHONE CHUCK BONDY AT: 519-919-4641

*PLEASE NOTE: YOU WILL HAVE TO SIGN A WAIVER WHEN VISITING THE MIRACLE LEAGUE FIELD FOR THE FIRST TIME.