Softball Camp 2019 Registration

State Fair Community College
Softball Camp
Registration/Consent Form

8-11 a.m. July 15-17
Centennial Park - Mandy Thomas Field

Player Information

What is the player's name? *

What is the player's date of birth? *

What is the player's street address? *

What is the player's city? *

What is the player's zip code? *

What is your telephone number? *

What is your player's email address (if applicable)?

Which grade will your player be attending in the fall? *

1 2 3 4 5 6 7 8

Which school will the player attend in the fall?

What is the player's favorite softball position to play? *

What is the player's T-Shirt size? *

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL

Parent Information

Parent's Name *

Parent's Street Address: *

Parent's City *

Parent's Zip Code *

Email address *

Parent's Phone *

Emergency Contact and Health Information

Emergency Contact's Name *

Emergency Contact's Telephone *

Emergency Contact's Email *

Emergency Contact's Relation to the Player? *

Medical Insurance Provider

Policy Number

Known Allergies

Date of Last Tetnus Shot

Additional Information

I declare that I am the (circle one) Father/Mother/Guardian of the above-named minor. *

Yes No

Please make checks payable to SFCC Softball Camp

By clicking the "Submit" button below...

I, the undersigned parent or legal guardian of the above-named minor do hereby consent and agree that the

above-named minor may participate in the SFCC Softball Camp. It is agreed that the named college, board members,

and officials assume no legal liability for injuries or other loss as a result of said participation. It is further agreed that

this consent shall remain in full force and effect until such time as the undersigned parent or legal guardian shall

notify the college in writing of the subrogation or cancellation of this consent.

I hereby certify that the SFCC Softball Camp staff has full and unconditional authority to proceed with diagnosis and

treatment as judgment indicates for injuries during camp. The SFCC Softball Camp shall not be held responsible for

any consequences resulting from injuries.

SFCC is an equal opportunity institution and is smoke and tobacco-free.

Visit sfccmo.edu to learn more.

* required field

Camps & Clinics

Softball Camp 2019 Registration