Panther Baseball Camp Registration

Print this form, complete it and mail to:
Panther Baseball Camp
540 E. Sycamore Ave.
Orange, CA 92866
Make check payable to: Chapman University

_____ June 28 - July 2
6-12 years old		 $190
 
_____ July 12-16
6-12 years old		 FULL
 
_____ July 19-23
6-12 years old		 $190
 
_____ July 26-30
6-12 years old		 $190
   
_____ Advanced Camp
August 2-5
10-14 years old		 $200
   

Camper's Name:_______________________________
Parent's Name:_______________________________
Camper's Age:__________ DOB:_________________
Address:_____________________________________
City:_______________________ Zip:____________
Home Phone:__________________________________
Cell Phone:__________________________________
Please note any medical conditions:_________________
_____________________________________________
Little League Affiliation:___________________
School:______________________________________
I hereby authorize the staff of Chapman University Panther Baseball
Camp to act for me according to their best judgment in any emergency
requiring medical attention. I consent to the above person participating
in these activities and assume the risk of accident or injuries from
whatever cause in connection therewith, and release the Chapman
University and their officers, agents and employees from any and all
liability for any such accident or liability.

_______________________________________
Parent/Guardian Signature