Baseball Classic Clinic Registration

American Girls Baseball Clinic Registration and Waiver

Monday, Nov. 20 • 9:30 am - Noon • Ed Smith Stadium Sarasota, FL
Player's Name*

First NameLast NameSuffix
Player Email
example@example.com
Player Phone
xxx-xxx-xxx
Player Address*

Street Address

Street Address Line 2

CityState

Zip Code
Age*
Birth date*

MonthDayYear
Please indicate your experience level:*
Player T-Shirt Size*
Parent/Guardian Name

First NameLast NameSuffix
Parent or Guardian Phone*
xxx-xxx-xxx
Parent or Guardian Email*
example@example.com

Medical Release and Authorization
Parents, please read this information and acknowledge it with your signature.
Permission is hereby granted to American Girls Baseball and its affiliates, including Directors, Coaches and Team Parents, to provide the needed emergency treatment prior to the child’s admission to a medical facility. You have our permission, in the event of an emergency and in case we are unavailable, to authorize any physician, nurse practitioner or medical personnel to examine, interview, test and, if necessary, treat my child, Name here* as they may deem advisable.
Please list any allergies the player has. If the player has none, please say "None."*
Please list any other medical problems the player has. If the player has none, please say "None."*
Name of player's primary physician:*
Primary physician's phone number:*
(###) ###-####
Name of player's insurance carrier:*
Insurance policy number:*
Safety Release: This releases and indemnifies AGB and its directors, officers, partners, staff, volunteers, consultants, representatives, and Baltimore Orioles Ltd. Partnership, from any and all claims and liabilities whatsoever arising from participation in or attendance at one or more of ABG's current or future programs by the undersigned, the undersigned's child(ren) or any associated spectator(s).

Covid Release: By signing this waiver, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk my child(ren) or I could be exposed to or infected by COVID-19 by attending AGB's Skills Clinic for girls and such exposure or infection may result in permanent injury, illness, disability or death. I understand the risk of becoming exposed to or infected by COVID-19 at the Clinic could result from the actions, omissions, or negligence of my child(ren), myself and others, including, but not limited to, AGB members, volunteers and program participants and their families.

I hereby release and forever discharge from any and all liability AGB, its directors, officers, partners, staff, volunteers, consultants, representatives, and Baltimore Orioles Ltd. Partnership. I expressly agree and promise to accept and assume all risks existing as a result of my child(ren)'s participation in the Clinic during a pandemic. Further, I agree to indemnify and hold harmless AGB from any claims that may be asserted against it as a result of said participation.

Media Release: Permission is granted by the undersigned for AGB and its agents to use the above-named child's video and likeness for the purpose of promotion of AGB in all forms, including, but not limited to, news, releases, photographs, videos, and recordings of the child to be used in print, digital, and internet media. The undersigned acknowledges that there will be no compensation for the images used and waives any right to inspect any printed or electronic copy. I hereby release AGB and its assigns of any claims that may arise from these uses. AGB will not use the name of any child attending the clinic in a photo or video without first obtaining permission from the parent or guardian of the child.

By signing this form, I acknowledge I have had sufficient opportunity to read it in its entirety. I have read and understand it and agree to be bound by its terms.
Signature of parent/guardian:*

Clear
Date*

MonthDayYear
Please verify that you are human*
The American Girls Baseball, Inc. is a 501(c)(3)charitable organization. All donations are deemed tax-deductible absent any limitations on deductibility applicable to a particular taxpayer. The tax deduction is limited to the excess of the contribution over the fair market value of any items received in exchange for the donation.
Should be Empty:

American Girls Baseball Clinic Registration and Waiver

Medical Release and Authorization