Rebels Baseball Campin conjunction with Youth

Baseball of RowlettHosted by Rebels Baseball coaches

July 28-316-8:30pmAges 6-14

Rowlett Community Park

$65 per player at registration on July 28th; $60 per player if registration is received by July 25th

$10 discount for siblings

Mail payment to:10709 Spyglass HillRowlett, TX 75089

INSTRUCTION IN THROWING, FIELDING, HITTING,

BASERUNNING, BUNTING, PITCHING AND CATCHING.

Questions: j_hitt@verizon.net

NAME: GRADE:_________ (Last) (First)

ADDRESS: CITY: ZIP:___________

PHONE: EMERGENCY PHONE: ___________________________

AGE: DATE OF BIRTH: ___________________________

T-SHIRT SIZE: YM_______YL______ S _____M_____L_______XL______

I grant permission to the Rebels Baseball Camp director, assistants or designees of the camp to act on my behalf for the minor designated above. In granting permission for evaluation/treatment of minor medical problems, I understand that if a major medical problem arises, an attempt will be made to notify me by phone. In the event that I cannot be reached, I hereby give my consent to such medical treatment as deemed necessary by a licensed physician. In addition, I hereby release Rebels Baseball, Youth Baseball of Rowlett and all its volunteers from all claims on account of any injuries which may be sustained by my child while attending the Rebels Baseball Camp. I also agree to indemnify Rebels Baseball, Youth Baseball of Rowlett, and all its volunteers for any claim which may hereafter be presented to my child as a result of any such injuries.

I HEREBY CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THIS AUTHORIZATION

Parent Signature ______________________________________________________Date__________________