metrobaseballcamp@charter.net

Please check session choice (need to make a check mark):
Cost is $100, minimum $50 deposit due with registration.

June 16-19
Camp A___________ Camp B___________ Camp C___________

Name _________________________________________________

Address________________________________________________

City________________________ State__________ Zip__________

Parent/Guardian__________________________________________

Telephone # ____________________________________________

Height_________________________ Weight__________________

Age________________ Birthday____________________________

Email Address___________________________________________

T-Shirt size requested: (please circle) Adult sizes: Sm. Med. Lg. X-Lg.

Complete One (check mark):

___________ Enclosed is $_______________________ Full Payment

___________ Enclosed is $___________________________ Deposit

I verify that my child has been checked by a licensed physician and is physically able to participate in the sports camp. I agree to allow my child to be treated by a licensed physician while attending, if necessary, and to assume all costs related to such treatment. I authorize the disclosure of medical information to my insurance company for the purpose of my claim. I understand that if this application is accepted, there is no refund of the deposit if we (parent of child) should cancel the application after June 10th. Hold Harmless Agreement: I and my heirs hereby release the Metro Baseball Camp and West Madison LL, ie. all its employees, officers and agents, from any liability for damages to or loss of personal property, sickness and injury, whatever the source, legal entanglement, imprisonment, death, loss of money, etc..., for which the Camp is not culpable, which might occur while participating in this workshop.

Parent/Guardian signature____________________________________