Bullpen Softball Private Lesson Interest Form

If you are interested in lessons, please fill out the questionaire below on player age, level and availabilty and we will get back to you shortly!!

Player Name:*

First NameLast Name

Player Date of Birth:

Date

Are you looking for baseball or softball lessons?*

SoftballBaseball

Parent Name:*

First NameLast Name

Email Contact:

example@example.com

Phone Contact: *

Area CodePhone Number

City:

Flood City Member or Non-Member:

Player Skill Level:

Interested in Private Lessons for the following (choose all that apply):

Players' playing experience (High School, Little League, Travel Ball Teams) and number of years for each:

Previous Private Instructors (If Applicable):

Availability for Instruction (please list days of week and times):

Any other info you think we should know!!

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:

Baseball/Softball Private Lesson Interest Form