Pitching Clinic Application and Release

Otero Junior College
Tippy Martinez Field
June 12 & 13, 2006
Monday & Tuesday

2006 Rattler Softball Pitching Clinic Registration Form

INSTRUCTIONS: Print out this Application and Release Form. You will need to print this form twice - one for the pitcher and one for the catcher. Fill out completely and return along with your $30.00 registration fee (pitcher only). You may also bring your registration form and check the first day of camp. Please print legibly!   Be sure to sign the waiver/release.   Pitchers only - Make check payable to OJC Softball.  Mail Application & Check to:

Otero Junior College
Attn: Jen Fisher
1802 Colorado Ave.
La Junta, CO 81050

This Application is for (circle one):                 PITCHER                CATCHER

Name:

Parents Name(s):

Address:

City:

ST:

ZIP:

Home Phone: (        )

Work Phone: (        )

Age:

Youth/Adult T-shirt? size:

For Pitchers Only - the name of your catcher:

___________________________________________

Person to contact in case of emergency:

___________________________________________
Phone:

___________________________________________

Waiver/Release:
I hereby authorize the Rattler Softball Camp Director to act for me according to his/her best judgment in any emergency requiring medical attention and I hereby waive and release the camp and its employees from any and all liability for any injuries and illness incurred while at camp.

____________________________________________
Parent/Guardian Signature

Pitchers only: Make check payable to OJC Softball