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2008 REGISTRATION
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Complete and Return by February 4th.
Walk up registrations after this date also welcome. |
| Name___________________________________________ Age as of May 1, 2008____ Date of Birth______________ Address_________________________________________ City/Zip_________________________________________ Home phone_____________________________________ Email Address____________________________________ T-shirt Size (check one)- Youth: __Small __Medium __Large |
| Adult: __Small __Medium __Large __XLarge |
| ___ Spring Training I ___ Spring Training II ___ Build Your Own Schedule (List dates below.) ___ Previous Attender (Year attended _______) ___ Early Bird Discount (registration before Jan 1, 2007) |
| Amount enclosed: $________ Balanced owed: $__________ |
| Pay and send to: | Greg Indlecoffer 4233 Oakcrest Drive Vadnais Heights, MN 55127 |
| Parent/Guardian Information First Name(s)_____________________________________ Work Phone(s)___________________________________ PARENTS/GUARDIANS RELEASE AND INDEMNITY AGREEMENT To GTCBS and Greg Indlecoffer: I/we hereby request that you accept this application for enrollment in the GTCBS during the dates set forth in this application and in consideration of your acceptance of this application. I/we hereby release GTCBS and Greg Indlecoffer and all its employees from all claims on account of any injuries that may be sustained by my/our son/daughter while attending the GTCBS; and I/we agree to indemnify GTCBS and Greg Indlecoffer and all its employees for each claim which may hereafter be presented by my/our son/daughter as a result of any such injuries. I/we also certify that my/our son/daughter is medically fit to participate in GTCBS and grant permission for medical attention if needed during GTCBS activities. Parent Signature__________________________________ Medical Insurance Company_________________________ List Flex Scheduling/Build Your Own Schedule dates: _____________________ _______________________ _____________________ _______________________ |