Cotuit Kettleers Baseball Clinics 2006 - Enrollment Form
For boys and girls ages 6-12, Monday thru Friday, 9:00 a.m. to 11:45 a.m.
(please print the form, complete ALL sections, and mail with payment to:
Cotuit Athletic Association, Box 443 Cotuit, MA 02635)  

Want to Pay for Your Child's Clinic Fee online? Click below:

Early Registration Payment

• Payment After June 1st, 2006
PLEASE PRINT CLEARLY

Child's First Name:________________________Last Name:____________________________

Child's DOB:_________ (must be age 6 by 6/1/06 and no older than 11 as of 9/1/06)

Parent's/Guardian's First Name: ____________________Last:________________________

Parent's/Guardian's PERMANENT Mailing Address:___________________________________

City______________________State___________Zip___________Telephone:_______________

Parent's/Guardian's LOCAL Summer Address: _______________________________________

City/Town____________________Emergency Telephone (during clinic hours):___________

Has your child attended before?_______If not, how did you hear about the program?

_________________________________________________________________________________

E-Mail Address: __________________________________________   

Youth Clinic fee enclosed: (Please circle one) $80.00  Early fee: $75.00 

 
Please mark requested session(s) -- multiple sessions and locations are permitted.
X=first choice  S=second choice

Dates Cotuit Centerville   Dates Cotuit Centerville
6/26-6/30 Session 1 ___  Session 1 ___ 7/17-7/21 Session 4 ___ Session 4___
7/3-7/7 Session 2*___ Session 2*__ 7/24-7/28 Session 5 ___ Session 5___
7/10-7/14 Session 3 ___  Session 3 ___ 7/31-8/4 Session 6 ___ Session 6___
*Session 2 - will not meet on July 4, 2006, but will meet M-W-TH-FR, 8:30-12:00

Please enclose a non-refundable check for $80 per child for each session requested - $75 if payment is received by June 1st.  APPLICATIONS WILL NOT BE ACCEPTED AT THE CLINIC SITES.  Checks should be made payable to: COTUIT ATHLETIC ASSOCIATION.  Please indicate a second choice in the event your first choice is not available.  A waiting list will be maintained when sessions are full.  Spaces will be allocated on a first come, first served basis as they become available.  Payments will be returned to waiting list applicants who are not placed in a session.  We make every effort to accommodate all interested children. Confirmations of enrollment, as well as clinic policies and procedures, will be sent to all applicants. It is understood that the Town of Barnstable, its School Department, its Recreation Department, the Cotuit Athletic Association, or their agents, assume no liability for accidental injury. All fees are non-refundable.

Parent/Guardian Signature: ______________________________________________________________Date:________________

Questions regarding policies and procedures may be directed to Joanne Crossen at (508) 428-8796 or jkcrossen@aol.com.