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Enrollment Form

Session Want To Attend:

Cost:

• The cost is $135 per person for all four clinics.
• A team discount of $10 per person is offered for 6 or more that signup as a group.
• $10 off the second or more siblings.

Name:
Date of Birth:
Address:
City/State/Zip:    
Phone  
Business Phone:
Mobile Phone:
Parent's Name:  
Emergency Contact Name:  
Emergency Contact Number:  
E-mail:  
Youth League Affiliation:  
Any Medical Condition we should be aware of:  
T-Shirt Size: (Youth)  
  (Adult)  

Tuition shall include the complete The Art Lopez Baseball Academy instructional program and camp t-shirt. Each camper is expected to observe the camp's rules and regulations. The director reserves the right to dismiss any camper who does not observe these rules and regulations.

All campers must have insurance coverage or agree to bear any medical costs that might occur while attending The Art Lopez Baseball Academy. I release The Art Lopez Baseball Academy, its owner(s), staff, and all associated agents from any and all liabilities from injury and illness incurred while at camp. I hereby give my permission for emergency medical treatment if I cannot be reached.
By checking the box below I acknowledge that the above form has been filled out correctly and all information provided is true and that I agree with all of the above terms and regulations.