ALCAN BASEBALL THROWING & PITCHING PROGRAM Printable Registration Form

ALCAN Baseball Printable Registration Form

THROWING & PITCHING PROGRAM REGISTRATION FORM

Please print out a copy of this form, complete, and mail to: ALCAN Sports, PO Box 80691, Fairbanks, AK, 99708
Or Drop off at Play It Again Sports or Sport King in Fairbanks.

If you have any questions please contact: ALCAN Sports: phone (907) 455-4203

NAME: _________________________________________ AGE: ____________________

ADDRESS: _______________________________________________________________

CITY: _________________________________ STATE/PROV.: _____________________

ZIP/POSTAL CODE: _________________________

PHONE: _________________________ DAY TIME PHONE: _______________________

EMAIL: ____________________________________________________________________

LAST TEAM/AGE DIVISION: __________________________________________________

YEARS OF EXPEREINCE: _____________________________________________________

HEIGHT: ________________________ WEIGHT: __________________________________

MEDICAL INFORMATION: (Allergies or any special conditions):__________________________

_____________________________________________________________________________

I WISH TO ATTEND & ENCLOSED IS A CHECK FOR THE FOLLOWING CAMP:

ALCAN Baseball Throwing & Pitching Program

Full Program ($400):___ *Deposit ($150):___

* Deposit is non-refundable with balance due upon check-in at camp.

ALCAN SPORTS and ADVENTURE INSURANCE WAIVER
The applicant, his/her parents and/or guardians, acknowledge that the sports and/or the activities herein may include risks of physical contact and injury, and agree ALCAN SPORTS, its agents, servants, employees, instructors, and directors, shall be held harmless and not liable for any injury or damage to the participants as a result directly or indirectly caused by attending the school. The applicant, his/her parents and/or guardians also agree to indemnify the UNIVERSITY OF ALASKA FAIRBANKS, THE LILY OF THE VALLEY CHURCH, and the FAIRBANKS NORTH STAR BOROUGH, their employees, agents, and managers from all claims and damages.

NAME OF PLAYER: ________________________________ DATE: __________________

SIGNATURE OF PARENT OR GUARDIAN: ____________________________________