FALL POP-UP CAMP REGISTRAITION

Tuesdsay, September 27, 2022

Player Information

Player's Full Name (First and Last)

Player's Date of Birth

Is there anything else we should know about your child? Allergies, medications, epi-pen needs?

Primary Emergency Contact Information

Primary Emergency Contact's Full Name (First and Last)

Primary Emergency Contact's Phone Number

Primary Emergency Contact's Email

Secondary Emergency Contact Information

Secondary Emergency Contact's Full Name (First and Last)

Secondary Emergency Contact's Phone Number

Secondary Emergency Contact's Email

Thanks for your registration. We will reach out to you soon.

Staten Island Orioles

Staten Island, New York

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