Click here for printable form

Sharonvill Location

510 E-Business Way
Sharonville, OH 45241
(513) 247-9511

Camp & League Registration Form

PLAYER NAME:__________________________

AGE:___ BIRTHDATE:________ 

BATS:   RIGHT   LEFT   BOTH   THROWS:  RIGHT   LEFT    POSITION(S): _________

PARENTS NAME: ___________________________________________________

ADDRESS:  ________________________________________________________

CITY:  ____________________________ STATE:  __________ 

ZIP: __________

HOME PHONE:  _________________________ 

WORK PHONE:  _______________

CELL PHONE:  ___________________________ 

FAX:  ______________________

***E-MAIL ADDRESS:  ________________________________

SHIRT SIZE:  ________

CAMP/LEAGUE NAME:  ________________________________________________

  RELEASE & CONSENT

I HEREBY AUTHORIZE CHAMPIONS BASEBALL ACADEMY OF CINCINNATI, L.L.C. TO ACT FOR ME, MY CHILD OR GUEST IN AN EMERGENCY AND HEREBY WAIVE AND RELEASE CHAMPIONS BASEBALL ACADEMY, INC. FROM ANY LIABILITY FOR ANY INJURIES OR ILLNESS SUSTAINED WHILE I OR ANY OF THE ABOVE PERSONS ARE IN ATTENDANCE AT ANY LESSON, CAMP, LEAGUE, OR ANY OTHER ACTIVITY. I FURTHER UNDERSTAND THAT ATTENDING A PROGRAM OF THIS KIND CAN BE DANGEROUS, DRILLS AND GAME SITUATIONS THAT ARE USED WILL CREATE THE DANGER OF BEING STRUCK BY BATTED BALLS AND BATS. I ACCEPT FULL RESPONSIBILITY FOR MY AND THE ABOVE STUDENT(S) MEDICAL BILLS, IF ANY, AND ALL OTHER ASSOCIATED EXPENSES AS A RESULT OF INJURIES OR ILLNESS SUSTAINED WHILE ANY OF SAID PERSONS ARE IN ATTENDANCE THE ABOVE STUDENT(S) IS ATTENDING THIS PROGRAM AT HIS OR HER OWN RISK.

 SIGNED BY PARENT OR GUARDIAN:  _____________________________________ 

DATE: _________________