
Champions is currently hosting a beginner and advanced
fastpitch clinic series at Terrell Mill Park in Marietta. This is a 3
week series that focuses on all the fundamental skills with throwing,
fielding, hitting and base running.
When: Saturday, November 5th, 12th, 19th
Time: 1:30 pm-4:00 pm
Cost: $85.00
T-Shirt: $12.00
*Deadline to register is Wed. November 2nd, all mail-in
registrations must be postmarked by Nov. 2nd. Late registration
fee: $20.00.
Please fill out the registration form below make checks
payable to Champions Fastpitch Academy and mail to:
Champions Training Center
505 Commerce Park Dr., STE I
Marietta, GA 30060
Registration
Name:_____________________
Age:_______
Address:______________________
City:___________Zip:________
*E-Mail:________________ ___Phone (H)____________Phone
(Cell)____________
T-Shirt: S M L + $12 Sweatshirt:
M L + $35
Amount Paid:______ Check #______
Release
Consent to Medical and
Release of Liability
I
hereby permit my child to participate in the Clinics/Instructional sessions
offered by Stacy Tamborra and Champions Fast Pitch Academy, Inc. . By the
execution of this release I acknowledge and agree that all requirements,
directions, supervision and standards set by the directors of this program
shall be established for his/her benefit. The person enrolling for
Champions Fast Pitch Academy Clinics, Lessons, or Instructional Sessions,
his/her parents or guardians assume all risk of loss of property or injury
to the person, including injuries associated with softball activities,
speed, and/or strength camps. I agree that there are inherent risks
associated to softball participation and therefore agree to hold Champions
Fast Pitch Academy and its employees harmless and specifically agree not to
make any claim against Champions Fast Pitch for any of these injuries which
may be considered normal risk associated with participation in softball
activity.
I
hereby voluntarily assume all risk of injury, of any form, to my child,
which may arise out of his/her participation in this program, hereby
intending to release Stacy Tamborra and personnel associated with this
program from liability that may result from his/her participation. In
addition, I hereby give my permission for emergency medical treatment in the
event I cannot be reached.
Parent/Guardian
Signature_______________________Date__________
Print Athlete’s Name_________________________________
Insurance
Carrier__________________________________
Policy
Number________________________________
*Feel free to call the Champions office for any questions
or registration at 770-792-1091.
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