Northeast Baseball and Softball Association... Wichita, Kansas

Player First Name:
Player Last Name:
Date of Birth:
Current Age:
Parent/Guardian:
Email:
Home Phone:
Cell Phone:
Address:
City:
Zip Code:
	Baseball Softball*
Primary Position:	Pitcher Catcher 1st Base 2nd Base 3rd Base Shortstop Left Field Center Field Right Field unknown
Friend Request:
Coach Request:
Team Request:
Consent Authorization:	Submission of this form does not require the payment of any fees.  All information will be used to develop a list of players for assignment to existing teams or creation of new ones.  All fees will be collected at a later date by a duly authorized agent. I understand contact information will be shared with coaches for the purpose of player assignment.
	I agree
Best contact method:	Email Address Home Phone Cell Phone