Registration

Fields marked with an * are required.

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Name

First Name

Last Name

Phone

Address

Street Address

City

Country

Date of Birth

Age

Primary Position

Bats

Right Left Switch

Jersey Size

Previous Teams played on?

Does your Child have any Medical Conditions? If so, Explain

Primary Physician, Physician Number, Health Insurance Company, Policy Number

Preferred Jersey Number(Cannot Guarantee availability)

I authorized South Bend Valor to use NIL of my Child(Photos & Videos)

Yes

WAIVER (Required)

I understand baseball involves inherent risks I release SB Valor Baseball, its coaches, volunteers, facilities, from liability for all injuries I certify that all information provided is accurate

Submission

I certify that all information submitted is true and accurate

Date

Parent/Guardian Signature

Full Name

Sign

Registration Fee

Select

Initial Deposit $250

Valor_ParentAgreement

Payment

Discount

Subtotal

Tax

Total USD

Registration

Ad

Payment

The form has been submitted.