Camp Registration Form

Please fill out the registration form below make checks payable to Champions Fastpitch Academy and mail to:

Champions Training Center
505 Commerce Park Dr., STE I
Marietta, GA  30060

Registration

Name__________________________  E-mail______________________

Camp Attending:_________________________  Camp Date: _________

Camp Session(s): □ All Skills □ Elite A/S  □ Pitching  □ Catching 

                 □ Adv. Hitting “A”  □ Adv. Hitting “Gold”

School:_________________________Age: ___Grade: ___T-Shirt Size: S M L

Address: ___________________City: ____________State: ____Zip: ______

Phone: _____________________ Cell/Work: _______________________

Payment Type: ________   Amount: ___________

 Release

Consent to Medical and Release of Liability

I hereby permit my child to participate in the Clinics/Instructional sessions offered by Stacy Tamborra and Champions Fast Pitch Academy, Inc. .  By the execution of this release I acknowledge and agree that all requirements, directions, supervision and standards set by the directors of this program shall be established for his/her benefit.  The person enrolling for Champions Fast Pitch Academy Clinics, Lessons, or Instructional Sessions, his/her parents or guardians assume all risk of loss of property or injury to the person, including injuries associated with softball activities, speed, and/or strength camps.  I agree that there are inherent risks associated to softball participation and therefore agree to hold Champions Fast Pitch Academy and its employees harmless and specifically agree not to make any claim against Champions Fast Pitch for any of these injuries which may be considered normal risk associated with participation in softball activity.

I hereby voluntarily assume all risk of injury, of any form, to my child, which may arise out of his/her participation in this program, hereby intending to release Stacy Tamborra and personnel associated with this program from liability that may result from his/her participation.  In addition, I hereby give my permission for emergency medical treatment in the event I cannot be reached.

Parent/Guardian Signature_______________________Date__________

Print Athlete’s Name_________________________________

Insurance Carrier__________________________________

Policy Number________________________________

*Any questions?? Feel free to call the Champions office or register at 770-792-1091.