DOMINICAN REPUBLIC WINTER BASEBALL TRIP
PLEASE FILL OUT ONE FORM PER PERSON.
  (*) indicates required fields print this page
INFORMATION REQUIRED FOR PARENTS AND PLAYERS
IMPORTANT:To pay remaining balance click here:
* Name as it appears on passport including any MIDDLE NAME OR INITIALS
* Passport number
* Address #1
Address #2
* City State Zip  
* Home Phone
* Cell Phone
* Parent's Email Address
Date of Birth
* Sex F
Golf Shirt size (ADULT S,M,L,XL,2XL,3XL)
* Everyone going on trip receives a golf shirt. Please enter adult size.
PLAYER INFORMATION
Position(s) played
Jersey Size & Number (Player only)
High School & Graduation Year
Colleges you are looking at

Payment Amount Non Refundable Deposit Of $1,000.00
Remaining balance:

Credit Card #
Expiration Date (mm/yy)
Card Type: Visa  MasterCard American Express
Card security code (3 or 4 digit code)
Make Checks Payable To:
Sal Agostinelli MLB Camp and Tournaments
(With printed copy of this form)
Dominican Trip
14 Ashland Drive
Kings Park, NY 11754

Questions:  info@salsbaseball.com or 631 979-0528