BASEBALL CAMP REGISTRATION

CAMP REGISTRATION FORM

Cost of Camp is $20 per child.

Please select how many players you are registering for camp.

Name of Player 1

DOB of Player 1

Month

Day

Year

Player 1 Age

Name of Player 2

DOB of Player 2

Month

Day

Year

Player 2 Age

Name of Player 3

DOB of Player 3

Month

Day

Year

Player 3 Age

Parent(s) Name

Parent Phone

Parent Email

WAIVER AND RELEASE FROM LIABILITY

We, the parents of the players listed above, agree that the coaches, counselors, organizers and township baseball board members shall in no way be responsible for any injuries suffered by him/her while engaged in

this camp sponsored by the Vancleave Youth Baseball League. Further, we hereby release the aforesaid of and form any and all liability for such injuries.

MEDICAL INFORMATION

Allergies

Medications

Medical Conditions

CONSENT FOR TREATMENT

I hereby give my consent to have the above applicant treated by emergency medical personnel, a physician, or surgeon, in case of sudden illness or injury while participating in the above activity. It is understood that Vancleave Youth Baseball League will provide no medical insurance for such treatment, and that the cost thereof will be at my expense. I have read and understood the foregoing registration liability release and parental consent form and agree to all of its terms and conditions.

Signature of Parent/Guardian

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Today's Date

Please select the correct number of registrations you are paying for

Camp for 1 Child$20

Camp for 2 Children$40

Camp for 3 Children$60