Little Rock Registration Form:

All new players play at least one season in the “Original League” before consideration is given to move to the Competitive League. If you have questions call 501-940-3405.

* Player First Name:

* Player Last Name:

School / Facility:

Team:

* Address:

* City:

* State:

* Zip:

* Gender:

Male
Female

* Birthday:

* Age:

Diagnosis:

Special Requests:

Special Needs / Requirements:

Parent/Guardian Name:

* Parent / Guardian Email:

* Parent/Guardian Email #2:

* Parent Occupation:

Address (if different from player):

* Home Phone:

Work Phone:

* Need a jersey?

By clicking "Submit"I hereby grant the Miracle League of Arkansas, it's affiliates, franchises, advertising and promotional agencies, and their agents, the irrevocable, unrestricted right to use, publish, display and distribute materials bearing my name, voice, likeness or and other identifiable representation of myself, my family members including my Miracle League player/child. These materials my appear in any form, style, color or medium whatsoever (including, without limitation, photographs, video tapes, films, sound recordings, software, drawings, prints, broadcast, internet and electronic media.) I agree that all material containing any identifiable representation of me (including without limitation, all negatives, plates and masters of any photographs, files, prints or tapes) shall be and remain the sole and exclusive property of the Miracle League. I hereby waive any right I may have to inspect or approve the finished materials or any part or element there of that incorporates my name, voice, likeness or any other identifiable representation of myself, my family including my Miracle League player/child. I have agreed to the above in consideration of the opportunity given to me by the Miracle League of Arkansas to appear in these materials. I acknowledge that I have have fully released and understand this document and that I have had any questions regarding its effect or the meaning of its terms answered to my satisfaction. I certify that I am at least 18 years of age, unless my parent or legal guardian also signs this document.

When you click the submit button below, you'll be directed to our payment page. From there click the "pay now" button to complete the registration process.