Player Information Sheet

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Baseball Manitoba
Team: ____________________________
Year: __________
PLAYER INFORMATION SHEET
(To be kept by Coach)
Player Name: ___________________________________________________
Phone: __________________
Address: _________________________________________________________________________________
City/Town: ______________________________________________
Postal Code: ___________________
Date of birth: Day ________ Month ________ Year ________
Height: _________ Weight: ________
Bat: ____ Right
____ Left
____ Both
Throw: ____ Right
____ Left
Team and Level played last year:
___________________________________________________________
School attending: ______________________________________________________
Grade: ___________
Parent(s) or Guardian(s) name: ______________________________________________________________
Address (if different than above):_____________________________________________________________
Parent(s) or Guardian(s) home phone (if different than above):_____________________________________
Parent(s) or Guardian(s) work phone and email:
Name: ____________________________
Email: ________________________________
Name: ____________________________
Email: ________________________________
Manitoba Medical Reg number (six digit): ________________________________
Personal Health ID number: _________________________________
Emergency contact (if different from above):
Name: ____________________________________________
Relationship: _______________________________________
Phone: ____________________________________________
Family doctors name: _____________________________________________ Phone: __________________
Hospital: _________________________________________________________________________________
Medical Info: Please list any allergies, medications or medical concerns:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Please provide Any other information that might be used in and emergency, or that coaches should be
aware of (i.e. previously broken limb)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Parent/Guardian signature: ________________________________________________________
Please return this form to the team coach
Personal information received from this form will be used by the coach of the team for purposes that include, but are not limited
to, providing emergency medical care and communicating information about the teams schedule, events and activities.
This information is not to be shared with any other person or company.

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