BCP Showcase Registration

PERSONAL INFORMATION

Name:

Address:

City, State, Zip Code:

Phone:

Cell Phone:

E-mail:

D.O.B.

MonthDayYear

Age:

Weight:

Height:

SCHOOL INFORMATION

High School:

Year Graduated:

GPA:

SAT Scores: Math, Verbal, Essay, Total:

ACT Score:

COACH INFORMATION

HS Coach Name:

Coach Phone:

Summer/Travel Team:

Summer Coach:

Phone:

Primary Position:

Secondary Position:

Bats:

Throws:

H.S.: AB

H.S.: Hits

H.S.: Avg.

H.S.: RBI

H.S.: Runs

H.S.: HR

H.S.: SB

H.S.: BB

Summer: AB

Summer: Hits

Summer: Avg.

Summer: RBI

Summer: Runs

Summer: HR

Summer: SB

Summer: BB

H.S.: W-L

H.S.: ERA

H.S.: H

H.S.: BB

H.S.: K

H.S.: IP

Summer: W-L

Summer: ERA

Summer: H

Summer: BB

Summer: K

Summer: IP

Select the sessions you would like to attend: Take $10.00 off each Showcase when registering for 2 or more!

Athletic Honors:

Academic Honors:

___________________________________________________________

PAYMENT INFORMATION

Check the box below if you wish to work at a position and pitch. There is an additional fee of $50, please add to your total.

(check this box)

Payment:

CC #:

Name:

Expiration:

Please enter the characters that appear on the image :

* if paying by check, make checks payable to: Blue Chip Prospects, PO Box 157, Bayport, NY 11705

DISCLAIMER: I do hereby release, discharge, indemnify and holdharmless Blue Chip Prospects, and its owners, directors, officers, employees, agents, successors,and assigns from and against, and waive any and all claims or liabilities for, any injuries, lossesor damages, including without limitations, injuries to my child, my self and/or property, arisingout of or incident to my child’s participations in Blue Chip Prospects. I hereby state that my child ismedically cleared for sports activities and has no underlying medical conditions which would affecthis/her participation. All payments are non-refundable including cancellation due to inclementweather. Player may apply registration fee towards future events. Permission is hereby given toBlue Chip Prospects to use photographs and/or endorsement of the players. Blue Chip Prospects is not responsible for any lost or stolen property.

Please check this box to confirm you have read our disclaimer:

BLUE CHIP PROSPECTS SHOWCASE REGISTRATION

STATS: Hitting-High School

STATS: Hitting-Summer

STATS: Pitching-High School

STATS: Pitching-Summer

2013 Schedule

Honors