Name *

First Name

Last Name

Birthdate *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Name *

First Name

Last Name

Phone *

(###)

###

####

Release of Liability *

I hereby authorize any and all coaches of AZ T-Rex Baseball Club to act on my or my minor child's behalf in case of illness or injury and to administer primary first aid. I hereby release any and all AZ T-Rex Baseball Club and staff from any and all liability from injury before, during, and after tryouts.

I agree