Pippins Camp Registration
Please fill out your child's details, guardian information, and acknowledge the liability waiver.
Camper's Full Name
*
First Name
Last Name
Camper's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Add a camper
Yes
No
Additional Camper Full Name
First Name
Last Name
Additional Camper Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Add more campers
Yes
No
Camper 3 Full Name
First Name
Last Name
Camper 3 Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Camper 4 Full Name
First Name
Last Name
Camper 4 Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Does the camper(s) have any special needs, dietary or health considerations?
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
ASSUMPTION OF RISK, RELEASE, AND WAIVER - the undersigned parent/guardian of the above-named minor participant (or the participant if 18+), hereby acknowledge and agree as follows: Voluntary Participation I understand that participation in the Pippins Baseball camp involves physical activity, including but not limited to throwing, catching, batting, running, sliding, fielding, and other baseball-related drills and games. These activities carry inherent risks of injury. I am aware that baseball activities can result in serious injury, including but not limited to: sprains, strains, fractures, concussions, dental injuries, eye injuries, permanent disability, or even death. I understand these risks exist even with proper supervision and equipment. On behalf of myself and the participant, I voluntarily assume all risks of injury, loss, or damage connected with participation in the camp, whether caused by the participant’s own actions or the actions of others. I hereby release, discharge, and hold harmless Pippins Baseball, its owners, directors, coaches, staff, volunteers, agents, and the owners of any fields or facilities used (collectively the “Released Parties”) from any and all claims, demands, actions, or causes of action arising out of or related to any injury, loss, or damage that may occur during or as a result of participation in the camp. In the event of an emergency, I authorize the camp staff to seek medical treatment for the participant and agree to be responsible for any medical costs incurred. I understand that the Released Parties do not provide any medical or accident insurance for participants and that I am responsible for obtaining my own insurance if desired. I grant permission for The Pippins to use photographs, videos, or other recordings of the participant for promotional purposes.
*
Parent/Guardian Signature
*
Register Camper
Register Camper
Should be Empty: