Rebate Request Form

Club Name*:

City*:

State*:

Name of Home Field*:

Member of VBBA since*:

Is your club affiliated with any league, historical society, or association in addition to the VBBA?*
 Yes No

If so, please name the organization:

Name of Club Captain*:

Street Address*:

City*:

State*:

Zip Code*:

Telephone*:

Email*:

Club Website:

Rules year your club is based on*:

Vendor from which items were purchased*:

Please list items purchased under terms of rebate program. Please list specific bat models, base ball types, uniform styles, etc.*:

By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.