UARM Baseball Prospect Camp Registration

Email Secondary Email

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Email address *

Name: *

Address:

Street, City, State, Zip Code

Date of Birth: *

Father's Name & Occupation: *

Mother's Name & Occupation: *

High School: *

ACT or SAT Score (Composite): *

Graduation Year: *

High School GPA (4.0 = A): *

Head H.S. Baseball Coach: *

Including Phone Number

Height: *

Weight: *

Primary Position: *

Secondary Position: *

Bats: *

Throws: *

Athletic Honors Received: *

Bob Carver Sports Performance Center

1360 S. Mena St., Mena, AR 71953

Cash or Check - $25.00

Make Checks Payable to "UARM Foundation"

* required field