The Baseball Center NYC: Registration Form

Class/Program Registration Form

Student’s Name:

E-mail:

Home Address: Apt #:

City: State: Zip Code:

Home Phone: Daytime/Work Phone:

Date of Birth: Age:

Male: Female:

Emergency Contact: Phone:

Physician Contact: Phone:

Known Allergies/Physical Limitations:

Parent Name:

Home Phone: Work Phone:

Parent Name:

Home Phone: Work Phone:

School:

Adult(s) and/or person(s) authorized to pick up child:

Class/Program Name	Date	Time	Fee
			$
			$
REGISTRATION FEE IS NON-REFUNDABLE AND NON-TRANSFERABLE		Total Fee:	$

Exp. Date: /

Name (as it appears on Card):

Signature:____________________________________________________________

Date Received __________ Received By __________ Date Processed __________
Processed By ___________________________________________
Check One: Cash: Check: Charge: Total Amount Paid $ _______________

CANCELLATIONS, REFUNDS & MAKE-UPS
1. The Baseball Center NYC reserves the right, prior to the first class or after, to cancel a course due to insufficient registration, with full refund.
2. Requests for program refunds must be submitted in writing no later than 2 weeks before the program begins. No refunds will be given after this date. (Please allow 4-6 weeks for processing). There is a $75 cancellation fee applied to all refunds.
3. Course fees are not transferable.
4. The Baseball Center NYC is responsible for make-up classes only if a cancellation is due to the absence of the instructor or the closing of the Baseball Center NYC facility. If you miss class, Inquire about the programs make up policy. Unfortuantely we do not offer make-ups for holiday bonanzas or summer camp programs.

MEDICAL & PHOTO RELEASE:
PARTICIPANT / PARENT, PLEASE READ CAREFULLY AND SIGN WHERE INDICATED BELOW FOR ANY STUDENT PARTICIPATING IN A CLASS:
By the very nature of the activity, sports carry a risk of physical injury. No matter how careful the participant and the coach are, risk cannot be eliminated. The risk of injury includes minor injuries such as bruises and more serious injuries such as broken bones dislocations and muscle pulls. I certify that the enrollee has no condition that prohibits full participation in the activities at THE BASEBALL CENTER NYC.

I understand and fully recognize that my child's participation in such sport activity program carries with it a risk of physical injury. I, on behalf of myself and my child, agree that The Baseball Center, its agents, employees, sponsors and volunteers shall not be liable to me or my child or our respective heirs or legal representatives for any injury or damage, however caused, resulting directly or indirectly from my child's participation in any Baseball Center sport activity program, at any time preceding, during or after such program is in session, and I hereby waive, and release and discharge The Baseball Center and its agents, employees, sponsors and volunteers from, any and all actions, claims and demands which I or my child may have in connection with any such injury or damage.

I understand and agree that The Baseball Center will not provide medical or health insurance for my child, and I will make separate arrangements to secure such insurance coverage if I deem it necessary. In the event of a medical or surgical emergency, I grant permission to the physician designated by The Baseball Center to hospitalize, secure proper treatment for, or order injections, anesthesia or surgery for, my child. Furthermore, I understand that payment for all such medical or surgical services is solely my responsibility.

I understand and accept all enrollment conditions. I authorize that The Baseball Center NYC has the right to use all photographs or videos taken of my child or me during camp/leagues/classes, etc. for advertising or promotional material.

I understand and comply with the rules and regulations described above.

Signature:________________________________________ Date:______________