Pitching Summit Registration Form

Pitching Summit Registration Form
* Payment is needed in full upon registration - see the bottom of this form for payment.

If you are in need of a payment plan, please contact us at Operations@TincherPitching.com IMMEDIATELY so we can help you, and you do not lose your spot.
Attendee Information

Please fill name and information of the pitcher who is attending.
Pitcher Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Age (must be 10+, this is an intensive event!)*
Age at time of Summit
Current Grade*
Current Team / Organization*
Do you currently work with a Tincher Pitching Certified Instructor?*

YesNo
If yes, what is your instructor's name?
Years of pitching experience:*
Level of Play:

Rec LeagueTravel / ClubHigh SchoolCollege
Pitch Types Currently Thrown:

FastballChangeupCurveballScrewballRiseballDropballOther
T-Shirt Size (Choose 1)*

Youth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XLAdult XXL
Parent/ Guardian Information
Parent / Guardian Name (primary)*

First NameLast Name
Parent / Guardian Name (secondary)

First NameLast Name
Parent/ Guardian Phone Number (primary) *
Please enter a valid phone number.
Parent/ Guardian Phone Number (secondary)
Please enter a valid phone number.
Parent/ Guardian Email Address*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Health & Safety
Allergies:*
Please describe any allergies the athlete has - (Food, Medication, Environmental, etc.)
Medical Conditions:*
Injuries:*
Emergency Contact Full Name:*
Emergency Contact Relation to Athlete:*
Emergency Contact Phone Number:*
Please enter a valid phone number.
Permission to Treat:*

I authorize event staff to secure medical treatment if neccesary
Insurance Information (optional)
Provider & Policy Number
Event Details & Permissions
What are your goals for attending this Summit?
Photo/ Video Release:*

I consent to my athlete's image being used for promotional purposes
Waiver & Liability Agreement:*

I understand participation carries risk of injury and release the organizers from liability.
Code of Conduct Agreement:*

Athlete & Parent agree to folow all event rules
Signature

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Payment & Policies

Full refund available within 10 days of registration (minus processing fees).. Option to transfer registration to another summit in the event of injury, sickness or family emergency.. Option to transfer registration to another athlete

My Products*

Basic AdmissionThis gives you a spot at the Summit! Expect two FULL days jam packed with everything you need to achieve your goals as a pitcher!

$799.00

VIP AdmissionAdmission to the Summit PLUS ... Exclusive additional merch, Virtual Analysis session with Abby Tincher Davis, Virtual Individual Movement Assessment with Miranda Abrahams McLeod, Level Up Game Simulator cards, Spin Fins, Tincher Pitching TruSpin softball, Pitching Workouts, exclusive vendor discount codes ..... and more! Over $350 in value!

$999.00

Enter coupon

Total

$0.00

***VIP ONLY***- Sweatshirt Size
How did you hear about the Summit?
Anything else you want us to know about your pitcher?

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Pitching Summit Registration Form

* Payment is needed in full upon registration - see the bottom of this form for payment.

Attendee Information

Parent/ Guardian Information

Health & Safety

Event Details & Permissions

Payment & Policies