Championship Softball Academy
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REGISTRATION FORM

PARENT'S NAME: _____________________________________________________________

PLAYER'S NAME: __________________________________________AGE:_______________

POSITION:____________

ADDRESS:_____________________________________________________________________

PHONE:______________________________CELL#:____________________________________

EMAIL :________________________________________________________________________

SIBLING DISCOUNTS: Take $5.00 off each additional child. Multi-camp discount: $5.00 off each additional clinic

PLEASE CHECK APPROPRIATE BOX: 

Clinic:  ______________________________________________________________________

Clinic Dates: ____________________________________ Amount Paid:__________________

Pitching: _____________________________   Hitting: ________________________________

Pitching Challenge Dates: __________________________ Amount Paid:________________

Hitting Challenge Dates: ____________________________ Amount Paid:________________

TOTAL AMOUNT PAID: ________________________  (cash / check # __________________)

I, the undersigned, waive, release and forever discharge Championship Softball Academy, Robin Payne and her staff and assign of and from all rights and claims for damages, injury, or loss to person or property which may be sustained or occur during participation in clinic activity or while at the clinic, whether or not damages, injury or loss is due to negligence.

I, the undersigned certify that _________________________________ is physically qualified to participate.

_______________________________________________________________________________

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