Child's Name                                                                                               
Age                                
Mailing Address    
Emergency Phone   
Home Phone   
Email Address   
Parent's Name   
Any Medical Issues   

***By Clicking Submit you are holding a spot in the MCLA Baseball Winter Clinic, Payment must be handled on the first day of the Clinic, Checks can be made out to MCLA Baseball and mailed to:

MCLA Baseball Office
C/O Jeff Puleri
375 Church Street
North Adams, MA 01247