Holy Spirit Baseball -

2012 Summer Camp Sign Up Form

Student Name*
FirstLast
Date of Birth (XX/XX/XXXX)*
Grade to be entered in the fall*
School*
Which Sport?*
T-Shirt Size*
Size choice not gauranteed.
Mother's Name (or legal guardian)*
FirstLast
Father's Name (or legal guardian)*
FirstLast
Home phone
Cell Phone*
Address*
Street AddressAddress Line 2CityStateZip Code
Emergency Contact*
FirstLast
Person listed above must be available during camp hours.
Emergency phone*
Parent Email*
Send me info for 2013 camps
- Yes
I hereby make application for my son and daughter to attend Hardball Baseball Camp held at Holy Spirit High School and pledge his or her compliance with all camp rules and regulations.
Signature of parent or gaurdian*
.
Emergency Health Information
I agree, that in case of an accident involving my child while attending this camp, baseball is an activity that may involve risk or injury. I release the Hardball Baseball Camp and Holy Spirit High School, its trustees, employees and servants from all and any liability. In case of an emergency, I give permission to the appropriate personnel to have my child properly transported to a medical facility for care. I understand that the Hardball Baseball Camp and Holy Spirit High School do not provide the medical expenses incurred. Please note any medical condition that the camp staff should be made aware of.
Date of last immunization*
Health Insurance Provider*
Group Number*
Account Number*
Doctor's Name*
Doctor's Phone*
I hereby authorize any medical treatment that may be advised or recommended for my child (write in name below)
*
while attending the Hardball Baseball and Softball Camp at Holy Spirit High School.
Signature of parent or gaurdian*

Registration is
not complete until check is received
in the mail.

$95 - Early Registration
Check postmarked on or before May 28.

$105 - Regular Registration
Check postmarked between May 29 - June 18.

$110 - Late Registration
Check postmarked after June 19.
Registration Details:

Mail and make check payable to:
Keith Gorman
105 Austin Ave
Absecon, NJ 08201

For questions please call:
609-646-300 ext. 315
kgorman@holyspirithighschool.com
Camp Details

Date: Monday, June 25th - Thursday, June 28th

Time: 9:00AM to Noon

Location: Holy Spirit High School, Absecon

Registration will be limited to the first 100 student athletes.

2012 Summer Camp Sign Up Form

.

Emergency Health Information

Registration is not complete until check is received in the mail.

Registration Details:

Camp Details

Registration is
not complete until check is received
in the mail.