Summer Camp 2010
Email form to allstaracademy@asa-mi.com or
Mail to 704 Van Etten, Pinconning , MI 48650
$100 (9 am – 12pm)
Baseball: June 7, 8, 9 / Ages: 9 & 10
Softball: June 21, 22, 23 / Ages: 10 & under
$150 (9am – 3pm)
Baseball: June 14, 15, 16 / Ages: 11 - 13
Softball: June 28, 29, 30 / Ages: 12 & under
Softball: July 6, 7, 8 / Ages: 13 & 14
Name:________________________________________________________________
Age:_______ Date of Birth:____/____/______ Grade:______
Parent/Guardian:_________________________________________________________
Home Phone:_______________________ Cell Phone__________________________
Email:___________________________________________________________________
Emergency Contact:____________________________Phone:_____________________
How did you hear about us?________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Release of Liability: I hereby give my consent to All Star Academy, LLC to provide reasonable and customary emergency medical services, if necessary, in the course of my child’s participation. I am fully aware of the hazards and risks associated with participation in athletic training. I further agree on behalf of my child, myself, me heirs and personal representatives to release, discharge and waive any and all claims against All Star Academy, LLC, their officers, directors, coaches, trainers, employees, agents, and volunteers from all claims or liabilities of any kind arising out of my child’s participation in athletic training or activities. In addition, I authorize the release of photos/videos take while training, which may be used for website display, training DVD’s or other promotional uses.
All Star Academy reserves the right to discontinue an athlete’s training at any time, for any reason, including any behavior or attitude that is distracting and a refund will not be granted. Our cancellation policy requires a minimum of a 12 hour notice if you need to reschedule a session, if you fail to call and cancel you will be charged for that day. As agreed upon, your training sessions are scheduled for a specific date and time; if you arrive late your time will not be extended.
I have read that information in full and understand the information presented. By submitting this form I authorize enrollment and participation in training for my child will All Star Academy as specified.
_______________________ __________________________
Parent/Guardian Signature Date
Baseball: June 7, 8, 9 / Ages: 9 & 10
Softball: June 21, 22, 23 / Ages: 10 & under
$150 (9am – 3pm)
Baseball: June 14, 15, 16 / Ages: 11 - 13
Softball: June 28, 29, 30 / Ages: 12 & under
Softball: July 6, 7, 8 / Ages: 13 & 14
Name:________________________________________________________________
Age:_______ Date of Birth:____/____/______ Grade:______
Parent/Guardian:_________________________________________________________
Home Phone:_______________________ Cell Phone__________________________
Email:___________________________________________________________________
Emergency Contact:____________________________Phone:_____________________
How did you hear about us?________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Release of Liability: I hereby give my consent to All Star Academy, LLC to provide reasonable and customary emergency medical services, if necessary, in the course of my child’s participation. I am fully aware of the hazards and risks associated with participation in athletic training. I further agree on behalf of my child, myself, me heirs and personal representatives to release, discharge and waive any and all claims against All Star Academy, LLC, their officers, directors, coaches, trainers, employees, agents, and volunteers from all claims or liabilities of any kind arising out of my child’s participation in athletic training or activities. In addition, I authorize the release of photos/videos take while training, which may be used for website display, training DVD’s or other promotional uses.
All Star Academy reserves the right to discontinue an athlete’s training at any time, for any reason, including any behavior or attitude that is distracting and a refund will not be granted. Our cancellation policy requires a minimum of a 12 hour notice if you need to reschedule a session, if you fail to call and cancel you will be charged for that day. As agreed upon, your training sessions are scheduled for a specific date and time; if you arrive late your time will not be extended.
I have read that information in full and understand the information presented. By submitting this form I authorize enrollment and participation in training for my child will All Star Academy as specified.
_______________________ __________________________
Parent/Guardian Signature Date