Concord Youth Beep Baseball Clinic Registration

Youth Beep Baseball Clinic Interest Form

Come learn how to play beep (blind) baseball with members of the Boston Strong! Open to kids ages 5-18 with a visual impairment. September 19 @ Emerson Field in Concord, MA.
Participant Name

First NameLast Name
Email
example@example.com
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Please Describe Your Disability
Emergency Contact and Phone Number
Any additional info you would like to provide:
Should be Empty:

Youth Beep Baseball Clinic Interest Form