* Required fields
Name *
E-mail Address *
Age(Must be 14-18 years old for Hitting Camp) *
Date of Birth *
Address *
Phone Number *
Emergency Phone Number *
Emergency Contact Name *
Camp Options: *
Baseball or Fastpitch Softball *
Team/League *
Payment Options: *
Current Centerfield Member? YES or NO *
Credit Card Number(Visa/MC/Discover Only)
Full Cardholder Name
Card Expiration Date
3-Digit Security Code(CVC) *On back of card*
Promo Code
Medical Conditions/Concerns
Where did you hear about the camp? *


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