::jeb dougherty baseball camps:: san diego

Complete one application per Player. Please fill out the entire registration form. After you submit your registration you will be prompted for your payment options.
Thank You and Swing Away -Jeb!

Player and Parent Details
Player First Name
Last Name
Players Age by April 31st 2008

Parent / Guardian First Name
Parent / Guardian Last Name
Home Phone
Moblie Phone
Address
City
State
Zip
E-mail

Please choose one of the following dates and locations:
Two day clinic or one day option?

La Jolla camp options
La Costa camp options
Pt. Loma camp options
Payment Options
Camp Shirt

Any health or other issues we need to be aware of ?
How did you hear about us?

I Certify that my child enrolled above is in excellent health and may participate in strenuous physical activities including baseball. I agree to defend and hold Jeb Dougherty Baseball Camp its servants, agents, and/or employees and contractors harmless from any and all claims for injuries sustained by my child during his or her participation in the camp. Permission is hereby granted to Jeb Dougherty Baseball Camp, to use pictures and any video footage of the campers in any promotional materials. Permission is granted for my child to receive emergency medical treatment, if needed, and I certify that there are no limits to my child's participation except as stated in writing and included with this application. Refunds can be given at the discretion of Jeb Dougherty Baseball Camp depending on the nature of the situation. Children who leave during the program due to injury or illness will receive a pro rata refund. A $15 handling fee will be required on any refund, no refund will be given for cancellation within 7 days of the camp start date. Children are enrolled on a fist come first served basis. We cannot guarantee enrollment any later than 5 days prior to camp. Should inclement weather affect the program, any lost hours will be made up later date.

Parent Initials Date ( mm/dd/yyyy )