Olmsted Girls Fast Pitch 2010

CLINIC FORM
(Please Print)

HITTING CLINIC DATES (3) Sessions PITCHING CLINIC DATES (3) Sessions
Saturday, April 10, 17 & 24 Sunday, April 11, 18 & 25

Olmsted Community Center 12 noon-1:30 pm Olmsted Community Center 2:00 pm-3:30 pm

Cost $45 / Player Cost $45 / Player

BASIC SKILLS CAMP DATES (2) Sessions

Player signing up for (1) or more Clinic(s) will received a T-shirt
Saturday, April 17 & 24
Please circle shirt size:
Olmsted Community Center 1:30 pm – 2:30 pm
Youth S / Youth M / Youth L / Adult S / Adult M
Cost $25.00 / Player

PLAYER INFORMATION
Player’s last name: First: Grade: School attending (circle one)

Falls Lenox / OFIS / OFMS / OFHS / Other ______

Parent(s) name: Birth date: Age as of 1/1/2010:

/ /

Street address: Home Phone # Cell Phone #

( ) ( )

City: State: ZIP Code:

For Pitching Clinic Only: Email: Information provided is for OGF Only.

Pitcher / Catcher NO Information is sold or distributed outside the organization.

MEDICAL INFORMATION
Does your child have any medical concerns, such as allergies, heart
 Yes  No
condition, asthma, etc. that OGF or their coaches should be aware of?
If YES Please explain:

RELEASE / CONSENT
The undersigned parent/guardian of the above named child does hereby give his/her consent to participate in the OGF program for the above named
season; which provide supervised fast pitch activities for the child. I agree to assume all risks and hazards incidental to the conduct of the OGF
sponsored activities; and I release, absolve, indemnify, and hold harmless the OGF, including its board of directors, and the organizers, sponsors, and
or any of the supervisors appointed by them. I likewise release from responsibility any person transporting my child to or from any activity.

Patient/Guardian signature Date

CLINIC FORMS CAN BE MAILED TO: Olmsted Girls Fast Pitch, P.O. Box 38086, Olmsted Falls, OH 44138

Questions? Please contact Chris Gallagher 440.478.4189 REGISTRATION DEADLINE: 4/1/2010

Please make checks payable to : Olmsted Girls Fast Pitch

For OGF use only

Check# / / Amount Rec’d $