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EmpireStateflyer

 

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Do you want to register for this event now ? please complete the form below and return in an email to EmpireStateFutureProspects@yahoo.com

 

 

Full Name – _____________________________________________________________

Mailing Address- ___________________________________Zip___________________

Email Address – __________________________________________________________

Phone Number – __________________________________________________________

High School – _____________________ Summer Team – ______________ Position – _____

Coach Name ( HS ) _____________________________(SUMMER BALL)_________________

Coach Email – ________________________Cell _________________________________

T-shirt Size – ___________Weight – ____________ Height – _________________________

Personal Insurance – ______________________ Ins # – ___________________________

Parent Name – ____________________________________________________________