PITCHING PROGRAM - Registration Form

Player’s Name: ________________________________________________________Shirt Size: SMLXL
Birth Date:_________________
Grade:______________Age:_________Sex: M / F
Parent/Guardian’s Name:________________________________________
Address:_____________________________________________________
City:_____________________________
St:_____ Zip:_____________
Phone: ______________________
Work :_______________________ Cell:________________________
Email Address: ____________________________________________________________________________
How did you hear about program?____Friend,____Email,____Flyer,____Ad Trenton Times,____Bucks Courier,____Trentonian

• Indicate emergency contact information:
1)
Name: __________________________________________Phone:_______________________________
2) Name: __________________________________________Phone:_______________________________

Medical Information:
EyeglassesContacts(Note: We do not administer medication.)
List medical problems, including allergies:____________________________________________________

• Try to group my child with:_____________________________________________________________

Pitching Programs
Saturday: Basic/Intermediate Pitching Clinics: Check your 1st, 2nd and 3rd  weekly  choice time slot.
Program includes 4 weekly sessions. Program begins Saturday, March 6th and ends Saturday, March 27th.
Program offers flexibility – Any missed sessions can be made up in week 5.  Cost of program is $150.00.

1st 2nd 3rd TIME AGE

9:00 - 10:00 a.m.
8 - 12
10:00 - 11:00 a.m.
8 - 12
11:00 - 12:00 p.m. 8 - 12


Wednesday: Basic/Intermediate Pitching Clinics: Check your 1st or 2nd weekly choice time slot.
Program includes 4 weekly sessions. Program begins Wednesday, March. 10th and ends March 31st.
Program offers flexibility – Any missed sessions can be made up in week 5.  Cost of program is $150.00.

1st 2nd TIME AGE

6:00 - 7:00 p.m. 8 - 12
7:00 - 8:00 p.m. 8 - 12


Available Discounts:
-
Family discount: Deduct 10% (2 or more children attending)
- Multiple program discount: Deduct 10% (player attending more than one program)
- Team discount: Call (609) 882-4873 for information.



I, the registrant/parent/guardian, by applying to participate in Steve Braun’s summer camp or winter programs
do hereby forever waive, release, absolve, indemnify, and agree to hold harmless Steve Braun Enterprises, Inc.,
the organizers and/or staff.

• Parent / Guardian Signature:
______________________________________________

To register print and complete this form and mail it along with check payable to:
Steve Braun Enterprises, P.O. Box 5173, Lawrenceville, NJ 08638.