Softball Private Lesson Interest Form
www.erasportsinc.com
Player Name:
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First Name
Last Name
Player Date of Birth:
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Month
-
Day
Year
Date
Parent Name:
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First Name
Last Name
Email Contact:
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example@example.com
Phone Contact:
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Format: (000) 000-0000.
City:
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Bulls Member or Non-Member:
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Please Select
Bulls Travel Member
Non-Member
Player Skill Level:
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Please Select
Beginner
Intermediate
Advanced
Interested in Private Lessons for the following (choose all that apply):
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Hitting
Pitching
Catching
Infield
Outfield
Throws
*
Please Select
Left handed
Right handed
Unsure (beginner)
Hitting
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Please Select
Left handed
Right handed
Unsure (beginner)
Players' playing experience (High School, Little League, Travel Ball Teams) and number of years for each:
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Previous Private Instructors (If Applicable):
Accident Waiver and Release of Liability Form & MediaRelease FormI HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANYACTIVIES ASSOCIATED WITH OR TAKING PLACE AT THE BULLPEN SPORTS CLUBincluding by way of example and not limitation, any risksthat may arise from negligence or carelessness on the part of the personsor entities being released, from dangerous or defective equipment or propertyowned, maintained, or controlled by them, or because of their possibleliability without fault.I certify that I am physically fit, have sufficientlyprepared or trained for participation in athletic activities and have notbeen advised to not participate by a qualified medical professional. I certifythat there are no health- related reasons or problems which preclude myparticipation in this activity.I acknowledge that this Accident Waiver and Release ofLiability Form will be used by THE BULLPEN SPORTS CLUB and organizersof any activity in which I may participate, and that it will govern myactions and responsibilities at said activity.In consideration of my application and permitting me toparticipate in this activity, I hereby act for myself, my executors,heirs, next of kin, successors, and assigns as follows:(A) I WAIVE, RELEASE, AND DISCHARGE from any and allliability, including but not limited to, liability arising fromthe negligence or fault of the entities or persons released, for my death,disability, personal injury, property damage, or actions of any kind whichmay hereafter occur to me including my traveling to and from this activity, THEFOLLOWING ENTITIES OR PERSONS: THE BULLPEN SPORTS CLUB and/or theirdirectors, officers, volunteers, representatives, and coaches. (B)INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the releasees from allliabilities or claims made as a result of participation in this activity,whether caused by accident or the negligence of releasee or otherwise.I acknowledge that releasees are NOT responsible for theerrors, omissions, acts, or failures to act of any party or entityconducting a specific activity on their behalf.I acknowledge that this activity may involve a test of aperson's physical and mental limits and carries with it the potential fordeath, or serious injury. The risks include, but are not limited to, thosecaused by terrain, facilities, temperature, weather condition ofparticipates, equipment, vehicular traffic, lack of hydration, and actionsof other people including, but not limited to, participants, volunteers,monitors, and/or producers of the activity. These risks are not only inherentto participants but are also present for volunteers.MEDIA RELEASE I understand while participating in activitiesat THE BULLPEN SPORTS CLUB I may be photographed. I agree to allow myphoto, video, or film likeness to be POSTED ON THE INTERNET and/orSocial Media for the purpose of college recruiting. I also give THEBULLPEN SPORTS CLUB permission to use my video and or likeness forpromotional purposes. Player Initials:The Accident Waiver and Release of Liability Form shall beconstructed broadly to provide a release and waiver to the maximum extentpermissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT ANDI FULLY UNDERSTAND ITS CONTENT THAT I AM GIVING UP MY RIGHT TO SUE. I AM AWARETHAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWNFREE WILL. I recognize that by signing this form I am agreeing tofollow all of the above, and if signing for my dependent that all statements above are agreed to for them as well
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Availability for Instruction (please list days of week and times):
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Ex: reading, golf, movies
Any other info you think we should know or to request a specific instructor!!
Submit
Should be Empty: