14U Signup Form

14U

Questionnaire

541 Division St. Building B Campbell, CA 95008OFFICE: (408) 866-8050 FAX: (408) 866-8088

Contact Information

Name:

Address:

City:

ZIP:

Phone:

Date of Birth:

Email Address:

Cell Phone:

Payment Information

Amount:

Credit Card Number:

Exp. Date:

Name On Card:

ZIP:

Billing Address:

CVV Code (back of card):

Baseball Information

Please select one option:

Position:

Pos 2:

Ht:

Wt:

Bats:

Throws:

High School:

Grad Year:

GPA:

Top 3 jersey numbers:

Jersey Size:

Payment Schedules

Fall Session:

8/16 - $150, 9/1 - $300, 10/1 - $300, 11/1 - $300

TOTAL = $1050

All Payments by: on-file credit card or Post-dated checks.

(Please make sure to fill out credit card information).