2010 Winter Clinic Session # 3 Registration Form

*Clinic:	Speed, Age 9-16, Tuesday, 7PM-8PM, Mar 23-Apr 20 Agility, Age 9-16, Saturday, 12PM-1PM, Mar 27-Apr 24 Advanced Baserunning, Age 9-16, Tuesday, 6PM-7PM, Mar 23-Apr 20 Pitching, Age 9-12, Sunday, 2PM-3PM, Mar 21-Apr 25 Pitching, Age 9-12, Monday, 6PM-7PM, Mar 22-Apr 19 Pitching, Age 9-12, Tuesday, 7PM-8PM, Mar 23-Apr 20 Pitching, Age 13-16, Sunday, 4PM-5PM, Mar 21-Apr 25 Pitching, Age 13-16, Tuesday, 8PM-9PM, Mar 23-Apr 20 Hitting, Age 9-12, Sunday, 1PM-2PM, Mar 21-Apr 25 Hitting, Age 9-12, Monday, 7PM-8PM, Mar 22-Apr 19 Hitting, Age 9-12, Tuesday, 8PM-9PM, Mar 23-Apr 20 Hitting, Age 9-12, Thursday, 6PM-7PM, Mar 25-Apr 24 Hitting, Age 13-16, Sunday, 3PM-4PM, Mar 21-Apr 25 Hitting, Age 13-16, Tuesday, 7PM-8PM, Mar 23-Apr 20 Hitting, Age 13-16, Tuesday, 9PM-10PM, Mar 23-Apr 20 FUNdamentals, Age 6-8, Monday, 6PM-7PM, Mar 22-Apr 19 FUNdamentals, Age 6-8, Sunday, 12PM-1PM, Mar 21-Apr 25 (hold the CTRL key to select multiple clinics)
*Name:
*Date of Birth:	(DD/MM/YYYY)
*Address:
*City:		*Postal Code:
*Home Tel.:		Bus. Tel. (Parent or Guardian):
*E-mail:
*Emergency Contact:		*Cell Num.:
	Release and Waiver of Liability: (Location: The Baseball Zone - 1081 Brevik Place, Mississauga, ON) In enrolling at The Baseball Zone, participant understands that he/she attending the programs and using The Baseball Zone and the facilities does so at his/her own risk. The Baseball Zone and its owners, employees or agents, shall not be liable for any damage whatsoever arising from any personal injury or property loss sustained by participant with his/her family in or about any programs on the premises. Participants and parents assume full responsibility for all injuries and damages which occur in or about any programs on the premises, He/She does hereby fully and forever release discharged hold harmless The Baseball Zone, all associated facilities and its owner, employees, and agents from any and all claims, demands, damages or rights of action, present or future resulting from any person’s participation in any programs or use of the facility. Consent: I the undersigned parent or guardian/participant do hereby grant authority to the staff at The Baseball Zone to render a judgement concerning medical assistance or hospital care in the event of an accident or illness during my absence. I do hereby authorize The Baseball Zone and its assigns to utilize any and all photographs, pictures or other likeness of me or anyone assigned guardianship to me, as they deem appropriate in its promotional materials or team films.
	I agree to these terms (If registrant 19 or older).		I agree to these terms (If registrant 18 or younger). Name of Parent/Guardian:
	Registration conditions: The undersigned also acknowledges that registration is not complete until a properly completed registration form and full payment including all applicable taxes has been submitted to The Baseball Zone and that there are no refunds, credits or make-ups for any missed sessions.
	I agree to these terms (If registrant 19 or older).		I agree to these terms (If registrant 18 or younger). Name of Parent/Guardian:
	Release for Medical Treatment:
	Health Card #:
	List of any conditions that The Baseball Zone Inc. and a physician(s) should be aware of:
* Fields marked with an asterisk are mandatory.