Issuu on Google+

Name:______________________________________________________________________________________

Address:___________________________________________________________________________________

Phone:_______________________________

City:_________________________

Email:__________________________________________

State:_____________

Zip:________________

Grad Year___________________

School:__________________________________

Emergency Contact:___________________________

Phone:___________________________________

Medical Release Waiver I hereby give my consent for myself & or my child to participate in all activities being conducted by The Catching Academy and declare that I will not hold The Catching Academy or Chris Burke Baseball their employees, contracted agencies, or any volunteer associates with the programs, responsible for any injuries, damage, or personal loss incurred while participating in said programs. The undersigned and the above named participant(s) are aware that the activities conducted by The Catching Academy both indoors and outdoors may result in serious injury and the participant(s) & or guardian assumes all the risk in participating in such activities. l/we also agree not to hold The Catching Academy liable for any injury sustained when my child is being instructed/coached or trained by The Catching Academy or any other sports facilities they may use. MEDICAL AUTHORIZATION

I understand that The Catching Academy its staff and all persons related directly or indirectly with The Catching Academy assume no financial obligation or liability; but in the case of accident or illness, I grant my authorization to secure medical treatment for the above named minor if I cannot be contacted immediately. I hereby consent to the administration of any and all medical procedures necessary by the attending authorities. Signed: ______________________________________________________________

Date: ______________

(Parent or Guardian if participant is under 18 years old)

Printed: _____________________________________________________

Relationship: _______________


Catching academy flyer reg form