Welcome to Steve Braun Baseball

Fielding and Throwing PROGRAM - Registration Form

Player’s Name: ________________________________________________________

Shirt Size: S

XL
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:

Eyeglasses

Contacts

(Note: We do not administer medication.)

List medical problems, including allergies:____________________________________________________

• Try to group my child with:_____________________________________________________________

Fielding and Throwing Program

Saturday: Fielding and Throwing Clinic: Check your 1^st, 2^nd and 3^rd 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 $140.00.

1^st	2^nd	3^rd	TIME	AGE

			3:00 - 4:00 p.m.	6 - 7
			4:00 - 5:00 p.m.	7 - 8
			5:00 - 6:00 p.m.	7 - 8

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.