LISA CAREY MARTIN & DJ CAREY SKILLS & BASERUNNING SOFTBALL CAMP 2026

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6425 SW 61ST STREET TOPEKA, KS 66610

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SESSION ATTENDING *

AGES 7 - 10 $75.00 9:00-11:30 times one session

AGES 11 -18 $75.00 12:00 - 2:30 times one session

NAME OF ATHLETE (First & Last) *

ATHLETE AGE *

ATHLETE PHONE # *

PARENT OR GUARDIAN NAME (First & Last) *

PARENT OR GUARDIAN EMAIL ADDRESS *

PARENT OR GUARDIAN PHONE # *

PARENT, GUARDIAN or EMERGENCY CONTACT PHONE # DURING CAMP TIME *

Liability Agreement

I, the undersigned, give my permission for the athlete noted above to participate in the instruction that was agreed upon by D.J. Carey and parent(s)/legal guardian(s) per signed skills agreement contract.

It is understood that participation in the aforementioned instruction may result in injury. Protective equipment does not prevent all injuries to participants. I do hereby waive, release, absolve, indemnify, and agree to hold harmless the coaches, volunteers, participants, and property associated with D.J. Carey Softball and Baseball Skills and Camps should injury occur. I hereby waive responsibility for injuries sustained on said property above.

Signature _____________________ Date _____________

Relationship to Athlete ____________________________

PAYMENT TYPE *

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