Baseball Instructional Showcase Camp

Name:
Home Phone:
E-mail:
Address:
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Zip:
Height:
Weight:
Throw R or L?	R L
Bats R or L?	R L
Desired Position 1:
Desired Position 2:
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Desired Position 4:
GPA:
PSAT:
SAT:
DOB:
Expected Date of Graduation:
Name of School:
Intended Major:
High School Coach:
High School Coach Phone:
Summer Coach:
Summer Coach Phone:
Please list 5 colleges or universities that may be of interest to you: Enter Credit Card Information	Exp Date:
Parent Consent Form/Waiver of Liability By signing this registration form and in consideration for being allowed to participate in this or any GO YARD Instructional Showcase Camp 2009 I represent that I am a parent/legal guardian of the applicant named within. I give permission for my son to be enrolled in the GO YARD Instructional Showcase Camp 2009. In addition, I am fully aware that baseball is an activity that may involve risk of injury and I authorize GO YARD LLC., and/or the instructors at the camp to act for me in securing medical treatment for my son in the event of injury and/or sickness. Registration also requires that you, as a parent/legal guardian sign below and agree that in case of an accident involving your child while attending the GO YARD Instructional Showcase Camp you forever release GO YARD LLC., it’s officers, directors, trustees, instructors, volunteers, coaches, trainers and agents (all of whom are herein referred to as “Releasees”) from, and agree not sue, “Releasees for any claims, loss, liability, demands, causes of action, costs, expenses included but not limited to attorney fees, damages or suits of any type, whether in law or in equity that may arise out of the applicant’s participation in the Showcase Camp activities I represent/certify that my son is in good health and able to participate in the physical activity of this vigorous athletic program without limitations. THERE WILL BE NO REFUNDS FOR ANY REASON. I, as a parent/legal guardian represent/certify that the applicant is covered by our family medical insurance program and that any/all costs incurred while participating in the GO YARD Instructional Showcase Camp will be paid through this family medical insurance program.
Signature of Parent/Legal Guardian:
Emergency Contact Numbers (List Two):
Insurance Policy #/Insurance Company:
For you convenience, we can accept VISA, MASTERCARD, AND AMX Print this form and Fax your credit card information to the number below, include credit card infomation in the "Credit Card Information" section above (please include credit card exp date). or send your completed form along with payment via US mail to: GO YARD, LLC. 45 RARITAN CROSSING, SUITE 6 RARITAN, NJ., 08869 FAX: 908-218-9894
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