sunday winstruction clinic_registration form

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  • 8/7/2019 Sunday WINstruction Clinic_Registration Form

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    Sunday WINstruction Clinic

    Sundays 4-5:30PM

    April 3 June 5 (excluding April 24, May 29)(weather permitting)

    Satterlee Henderson Field, St. Albans School

    Ages 9-12

    Cost $20 per session - OR - $140 for all 8 sessions

    Skill Development Focus Areas

    Throwing proper arm action and careHitting dynamic fundamentals and controlled power

    Fielding basic instruction and instinctual playPositioning breakout stations for pitching, catching, infield and outfield

    Pitching arm care and mechanical efficiency

    Featured Instructors

    Jason Larocque:

    Head Coach St. Albans School, Executive Director Win Within BaseballTBD

    www.winwithinbaseball.blogspot.com

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    SUNDAY WINstruction CLINIC

    REGISTRATION FORM

    PLAYER NAME ________________________________________ DOB_________________

    PLAYER ADDRESS_________________________________________________________________

    CITY _________________________ _____________ STATE ________ ZIP ____________

    PLAYER HOME PHONE _________________________

    PLAYER POSITIONS _______________________________________________________________

    PREFERRED INSTRUCTIONAL FOCUS _______________________________________________

    PARENT #1 NAME_____________________________ BEST PHONE #_____________________

    PARENT #1 EMAIL _________________________________________________________________

    PARENT #2 NAME ____________________________ BEST PHONE #_____________________

    PARENT #2 EMAIL _________________________________________________________________

    EMERGENCY CONTACT NAME ____________________________ PHONE _______________

    RELATION TO PLAYER _____________________________________________________________

    Program Philosophy

    Win Within Baseball was created with the idea of serving the athletic, social, anddevelopmental needs and aspirations of local baseball players and their families. Program goalsinclude the development of young athletes as competitors and productive members of theircommunity. Winning is important, but teaching lessons about accountability, responsibility,

    team-building, sacrifice, and selflessness will be a strong focus of our instructors and programs.

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    Waiver of Liability and DisclaimerI/we know that participation in the sport of baseball may result in serious or deadly injuries andprotective equipment does not prevent all injuries to players. I/we hereby waive, release, absolve,

    indemnify and agree to hold harmless Win Within Baseball, the organizers, participants, andcoaches from any claim arising out of the injury to my/our child whether the result of negligenceor any other cause. In the event of an emergency where medical treatment is needed and I/we areunreachable, I give permission to the coaches/instructors to secure proper treatment and medicalcare for my child.

    In no event will Win Within Baseball be liable for any damages, including without limitation,direct or indirect, special, incidental, moral or consequential damages, loss of profits,opportunities or information or for expenses arising in connection with any services provided.

    PARENT NAME _________________________________ DATE ________________

    PARENT SIGNATURE ______________________________________________________

    Please sign and return this form with a $140 check made payable to Win Within Baseballto reserve your clinic spot. Forms can be mailed to:

    Jason LarocqueSt. Albans School

    Mount Saint Alban NWWashington, DC 20016

    Questions? Email [email protected] or call 202-409-4874.

    www.winwithinbaseball.blogspot.com