Elmer, NJ      856-469-3845
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On-Line Camp Registration
Please fill in all information below in the fields, once you have completed the form, please click submit and have your credit Card ready for payment through our "PayPal" secure account. If you would like print and mail a check with the form to Harry Rodriguez please send it to 1393 Morton Ave, Pittsgrove Township NJ 08318

PLAYERS FULL NAME:

PARENT / GUARDIANS NAME:

AGE: DOB:

EMERGENCY CONTACT:

HOME PHONE: WORK PHONE:

ADDRESS:

PARENT'S EMAIL ADDRESS:

SHIRT SIZE:

Camp attending:



 
              
   
 
  

 

  
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