WINTER 2022 BALLFX TEAM REGISTRATION

Athlete Information

Athlete's Name*

First Name Last Name

Name of School*

City of School*

Birth Date*

Month Day Year

Age as of Sept 1st 2022*

Age division as of Sept 1st 2022*

Grade as of Sept 1st of current year*

Area of Interest

Graduation Year*

UPLOAD A COPY OF ATHLETE'S BIRTH CERTIFICATE

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Height (in feet and inches)

Gender*

MaleFemaleWish not to disclose

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Jersey Size

T-Shirt Size

Parent/Guardian Information

Name*

First Name Last Name

Home Number

Area Code Phone Number

Cell Number*

Area Code Phone Number

E-mail*

Emergency Information

Emergency Contact's Name*

First Name Last Name

Relationship

Phone Number

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Insurance Carrier

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please explain any instructions.

Are you registering more than 1 child?*

YesNo

If yes, list the additional athlete's Name, Age, Grade, Uniform Size

Confirmation

BY ACKNOWLEDGING AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

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My Products

Team Access & Skills Training$599.00

FULL SEASON includes: TEAM PRACTICE, SKILLS TRAINING AND TEAM PRACTICES

Quantity

JUNIOR BALLERS (1st - 3rd grade) Team Access & Skills Training$499.00

FULL SEASON includes: TEAM PRACTICE, SKILLS TRAINING AND TEAM PRACTICES

Quantity

Team Access Only (4 Session Monthly Membership Training Package Already Purchased)$299.00

NOTE: CLICK THIS OPTION ONLY IF SKILLS TRAINING MEMBERSHIP WAS ALREADY PURCHASED VIA BALLFXGLOBAL.COM

Quantity

ONE-TIME UNIFORM PACKAGE FEE (NEW BALLFX TEAM MEMBERS ONLY)$100.00

Includes: Reversible Jersey and Shooting Shirt

Quantity

OTHER PAYMENT OPTION $ Free

CLICK ONLY IF YOU HAVE ALREADY PURCHASED THE 3 MONTH INSTALLMENT PLAN VIA BALLFXGLOBAL.COM or IF YOU HAVE ALREADY PAID IN FULL VIA ZELLE OR CASHAPP

Enter coupon

Total $0.00

Payment Methods

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Please click one of the PayPal options to complete payment and submit the form.