George Foster Baseball Clinic

Download Application And Mail With Payment To:

Summer 2009 George Foster Baseball Clinic Registration Application

Mail this application and make checks payable to:

George Foster

15 East Putnam Avenue Suite 320

Greenwich, Connecticut 06830

203.618.0057 www.georgefosterbaseball.com

georgefosterbaseball@yahoo.com

Mail Your Registeration Form With Payment

~or~

To Reserve Your Spot IMMEDIATELY

TODAY By Paying ONLINE At The GFBC Store

and Mailing Your Registration Form

Application Deadline: June 1st, 2009

Download Application And Mail To:

In case of emergencyLPlease fill in the following:

___________________________        _____________________________________

                Camperfs Name                                            Parentfs Name

Parent Phone#___________________  Parent Cell# _________________________

Parent Work# ___________________  ParentEmail:________________________

Insurance Carrier: ___________________________  Policy # ___________________

Physician: _________________________________  Physical Date: ______________

Other Emergency Contact:

_____________________________    ___________________   __________________

                     Name                                   Relationship                     Phone #

_____________________________    ___________________   __________________

                      Name                                    Relationship                    Phone#

I hereby authorize the medical designates of George Foster Baseball Training Academy to administer health checks, routine care and any urgent or emergency treatment considered necessary by the camp physicians or their assistants.  I desire that notification of such illness/injury be made to me or other said designated person immediately.  I understand that I am responsible for any bills related to hospital or doctor visits regarding any illness/injury to my child.  By signing this registration I accept full responsibility for all incurred program fees and expenses.

In addition, to information above I certify that my child ___________________has a physical and is covered by health and accident insurance.

_________________________________        _________________________

  Print Parent/Guardian Name

George Foster Baseball Training Academy

To register, fill out all information and return/mail or email.

Last Name:___________________________  First Name: __________________ Nickname:______________

Address: _____________________________ City: ___________________  ST___  Zip Code: ____________

Birth Date:___/_____/_____  Grade: _____  Age:____  School: _____________________

Team:  School (V or JV)    League: _________________  SpecialTeam:   _______________________

Position 1: ___________________  Position 2 :__________________ T-shirt:  S  M  L  XL  XXL

Resident Roommate: ___________________   Commuter    Attended Last Year

Physical Date: _____________        Physician Name:____________________ 

Insurance Company: ___________________________  Policy #: ____________________

Father Name: ________________________  Address: (if different)_______________________________

Home Phone: (____)_______________  Cell Phone: _________________  Email: ______________________

Mother Name: _______________________  Address:(if different)________________________________

Home Phone: (      ) ________________  Cell Phone: _________________ Email:______________________

Parental and/or Applicant Release

We (I) _____________________  hereby request you accept the application for ____________ at George Foster  Baseball Training Academy (GFBTA).  I have read and thereby accept the conditions described in the brochure.  In consideration of our acceptance, we (I) hereby release or hold harmless George Foster Baseball Training Academy (GFBTA) and __________________ of all their employees and agents of any clams, liabilities, demands, damages, injuries and illness whatsoever including without limitation to any person (s) and /or property or right of action present or future, where anticipated or unanticipated, resulting from or arising out of playerfs participation and attendance at GFBTA.  George Foster  Baseball Training Academy (GFBTA) retains the rights to use, for publicity, promotions, and advertising purposes. 

Parent Signature: ________________________________  Parent Print __________________________

(Required under 18) Date: _________________________

Applicant Signature: ______________________________  Applicant Print: ______________________

Applicant Date: __________________________________ 

CANCELLATION:  The registration fee ($100) is non-refundable, but can be transferred in the campers name to another session this year or the following year.  If a camper has to withdraw from GFBTA for an illness or injury, the tuition will be credited to the following year.

Application Deadline: June 5th, 2009

Mail Your Registration Form With Payment

~or~

To Reserve Your Spot IMMEDIATELY

TODAY By Paying ONLINE At The GFBC Store

and Mailing Your Registration Form

Session Dates (Please Select Week/Weeks Attending):

Sessions Are $350.00 per week including lunch.

Locations: Chestnut Park, Stamford, CT 06901

Times: 9am to 3pm Monday to Friday

Ages:  8-and above

Application Deadline: June 5th, 2009

_____SPECIAL! PreSeason Campers: Week of June 15th - 19th

_____Session 1: Week of June 29- July 2nd

_____Session 2: Week of July 13th-17th

_____Session 3: Week of July 20th-24th

_____Session 4: Week of July 27th-31st

_____Session 5: Week of August 3rd-7th

♦ Register for all Five Sessions & Receive 10% Off The Total Tuition

  Tuition   _____   $350 per week X ____ week(s)

 _____   Total Amount Enclosed            ~ Gift Certificates Available~

Application Deadline: June 5th, 2009

Mail Your Registeration Form With Payment

~or~

To Reserve Your Spot IMMEDIATELY

TODAY By Paying ONLINE At The GFBC Store

and Mailing Your Registration Form