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2011 SKYLINE SOFTBALL SUMMER CAMP REGISTRATION

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2011 SKYLINE SOFTBALL SUMMER CAMP REGISTRATION Powered By Docstoc
					               2011 SKYLINE SOFTBALL SUMMER CAMP REGISTRATION
NAME: ________________________________________________________________________________
DATE OF BIRTH: ___________________ AGE: _____ GRADE: _____ HS GRADUATION YR: ___________
EMAIL: (print clearly) _____________________________________________________________________
MAILING ADDRESS: _____________________________________________________________________
CITY: ____________________________________________ STATE: _____ ZIP CODE: _______________
HOME PHONE: _______________________________ EMERGENCY PHONE: _______________________
PARENT/GUARDIAN NAME: _______________________________________________________________
CELL OR WORK PHONE FOR PARENT/GUARDIAN: ___________________________________________
Please check the camp(s) you are registering for:
                                      Camp                                      Date           Deposit       Total      Pitcher/Catcher
                                                                                                Due          Cost           Position

         Day Camp                                                       June 13-16          $100          $120

         Pitcher & Catcher Camp                                         June 26-28          $200          $275          P or  C


         Hitting Camp                                                   June 26-28          $200          $275

         All-Position Camp                                              June 28-30          $200          $325

         All-Position Camp + Pitcher/Catcher Camp                       June 26-30          $400          $525          P or  C


         All-Position Camp +Hitting Camp                                June 26-30          $400          $525


Discounts: (Please note only one discount allowed per registration)
         $15 off early registration discount if received before May 15 (applicable to pitcher/catcher, hitting, and all-
          position camps only)

         $10 off for second family member discount (applicable to all camps)

         $10 off for bringing a friend discount (submit applications together; applicable to day camp only)

         $10 off early registration discount if received before May 15 (applicable to day camp only)

Roommate Preference: (for overnight camps only) _______________________________________________
               DEPOSIT IS DUE WITH REGISTRATION; BALANCE DUE IN FULL AT CHECK-IN.
                  Deposits are non-refundable. Make checks payable to Skyline Softball.
                                TOTAL ENCLOSED: $_____________________
FOR OFFICE USE ONLY:
_________________________________________________________________________________________________________________
Name                                Date Rcvd             Bank/State           Check #               Session

*REQUIRED: MEDICAL RELEASE: All campers must have their own medical coverage. Campers will not be allowed to participate
unless the following information is submitted and the separate form signed by the parent or legal guardian of the camper. Please com-
plete the health insurance and medical information form and return with your registration form.
CAMPER’S INSURANCE COMPANY: _____________________________________________ POLICY #: ________________________________
COMPANY’S ADDRESS: ______________________________________________________ PHONE: __________________________________
*REQUIRED: WAIVER STATEMENT: All campers must have a release and waiver form signed by parent or legal guardian before
they will be allowed to participate. Please complete a release and waiver form and return it with your registration..

  **Please make sure a legible email address has been included above on this form so that necessary forms
                   can be emailed to you for your prompt return to the address below.**
                            PLEASE COMPLETE ALL SECTIONS AND MAIL TO:
                                      SKYLINE SOFTBALL, LLC
            395 S. High St, MSC 6925, MEMORIAL HALL 1150, HARRISONBURG, VA 22807

				
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