2018 Harlan Baseball Clinic Registration
Email address *
Your Name *
Your answer
Age *
T-Shirt Size *
Contact Phone Number *
Your answer
Your Email Address *
Your answer
Parent's Signature *
Your answer
Insurance Information
If you have no insurance please type “No Insurance” below.
Insurance Company *
Your answer
Policy Number *
Your answer
By submitting this form, I hereby certify that the above information is accurate and I give my permission for the use of photographs and videos of my child and myself to be used in Harlan Christian School and Harlan Park Athletic Association publicity and for my child to be transported to and from off-site activities; for the release of medical records in case of illness or inury; and for this registrant to engage in all baseball activities, except as noted by me and/or an attending physician. If no insurance is available, the Harlan Christian School or Harlan Park Athletic Association is not liable for any and all accidents that may occur during our sponsored activity. (type your name in the place of signature)
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