Registration: Camp Intern
Please note:  Registration will not be accepted unless BOTH, this form AND Payment (either deposit or payment in full) are completed.
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Email *
Intern Last Name *
Intern Preferred First Name *
Intern Legal First Name *
What is your preferred camp for internship *
Tee Shirt Size *
Intern age at time of Camp *
Intern School *
Camper Coaches (school and/or travel) with Phone Numbers for reference if needed *
Other references (with phone numbers) you'd like for us to call if needed:  teachers, youth ministers, etc. *
Mom's name *
Mom's email *
Mom's cell phone *
Mom's address *
City *
Zip *
State *
Dad's name
Dad's email
Dad's cell phone
Dad's address
Dad's city
Dad's zip
Dad's State
Emergency Contact's name (other than parent) *
Emergency Contact's cell phone
In 150 words or more, please have intern describe why he desires to serve as an intern at Baseball Crosstraining and how he believes God can use baseball as a tool for you to make an impact for Christ.   *
Primary Insured's Name *
Insurance Company
Policy number *
ID number *
 I understand that further information concerning roommate requests, positions played, adjustments in shirt size, medications to be administered, etc. will be sent via email and that I must regularly check in order to keep my child's application up to date. 
 *
Required
Parent/Guardian Agreement,  I/we, the undersigned, hereby certify that I/we am/are the parent or legal guardian of the camper, and hereby give permission for the staff of the Baseball Crosstraining camp to seek, during the period of the camp, what they deem appropriate medical attention for the camper and for the medical attention to be given and for the camper to receive medical attention.  In the event of an accident, injury, or illness, I will be responsible for any and all cost of medical attention and treatment, except for that covered by the camp's secondary medical coverage policy.  I/We, the undersigned, for ourselves, our heirs, executors and administration waive, release and forever discharge Harding University, Harding Academy, Shane Fullerton, the camp, and it's staff, officers, agents, employees, representatives, successors and assign of and from all rights and claims for damages, injuries or loss is due to negligence.  Campers will not be allowed to play unless the information is submitted and this form signed by the parent or guardian of the camper.  (Please type your name to confirm that you have fully read and fully agree to this.)

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A copy of your responses will be emailed to the address you provided.
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