WINTER CLINIC REGISTRATION
Last Name:
First Name:
Age:
Current Grade:
Shirt Size:
Street:
City:
State:
Zip:
Phone:
Emergency Phone:
Parent's Name:
Email:
Alternate Email:
Summer Team:
Summer Coach:
Payment Type:
If Check, Mail To: OTHS Baseball, 600 South Smiley, O'Fallon IL 62269
If Credit, enter #:
Name on Card:
Expiration Date: