Payment Information

The Ripken Experience – Myrtle Beach 2017 Summer Collegiate League Registration Form

Player Name: Address:

Home Phone:

Cell Phone:

City:

State:

Zip:

Email Address: Parent/Guardian/Emergency Contact Name:

Home Phone:

Address:

Cell Phone:

City:

State:

Zip:

Email Address:

Current Baseball Year (example Junior):

Players Current College: College Head Coach:

School Phone:

Address:

Cell Phone:

City:

State:

Zip:

Email Address: Primary Position: Jersey Size:

Secondary Position: ___________Interested in Ripken Summer Internship (Y/N):______ Fitted Hat Size:

Would you like assistance locating a summer job (Y/N):________

Requested Team (Leave blank if no coach has spoken with you): Player Package (please check one):

Payment Information

□ Play Only Package (player does not require lodging): $1500 □ Stay & Play Package (player requires lodging): $2000 Deposit: $500 due at the time of registration; this is non-refundable.

□ Check or Money Order (made payable to The Ripken Experience) □ Credit Card (circle one): AMEX Visa Mastercard Credit Card/Check Number: Amount:

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Expiration Date: Cardholder Name:

Security Code: