Cotuit Kettleers Baseball Clinics Registration Form

Cotuit Kettleers Girls' Softball Clinics 2006 - Enrollment Form
for girls ages 9-13
(please print the form, complete ALL sections, and mail with payment to:
Kettleers Softball Clinic, 77 Spur Lane, Marstons Mills, MA 02648)

PLEASE PRINT CLEARLY

Child's First Name:________________________Last Name:____________________________

Child's DOB:_________ (must be age 9 by 6/1/06 and no older than 13 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: _______________________________________________________________

_________________________________________________________________________________

2006 Clinic Sessions:

___

n/a

___

n/a

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 submitted are non-refundable.

Parent/Guardian Signature: ______________________________________________________________Date:________________

Medical carrier and policy #: ____________________________________________________________________

Questions regarding policies and procedures may be directed to Bruce Murphy, 508 428 3358 or bmurpfcape@aol.com