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Grand Slam
Clinic Registration Form
FULL LEGAL NAME: _________________________________________________________________
ADDRESS: ___________________________________________________________________________
CITY: _____________________________________________ STATE: _______ ZIP: _______________
PHONE: (______) _____________________ EMERGENCY PHONE: (______)____________________
EMAIL ADDRESS: _______________________________________ BIRTHDATE: ________________
MM/DD/YY
Place a number “1” after your first choice and a number “2” after your second choice. If your first choice date is filled you will be given your second choice automatically.
Basketball
____ (Individual Workout) [No. of sessions]:___ ___ (Group Drills) [No. of sessions]:____ ____(Traveling clinic)
____ (Specialized Clinics) [Area(s) of need]:________________________________ ____(Full 5-Day Basketball Camp)
Basketball ‘Coaches’
____ (6-hour Coaches Clinic) $60 ____ (Full 12-hour Coaches Course) $75
Softball
____ ( Softball Boot Camp) $240 ____ (Nine Week Softball Hitting League) $150 ____(Softball Pitching Basics) $100
____(Advanced Softball Pitching) $100 ____(Softball Fast Pitch Hitting Clinic) $100.00
Baseball
____(Personal Instruction 30 min) $40 ____(Personal Instruction 60 min) $80 _____(5) 1 hour sessions $320
____(10) 1 hour sessions $560
I have read and approved the dates, price, and cancellation clauses as they appear in the Grand Slam contract. I am also aware of the scope of this training program and shall make no claims against Grand Slam, its instructors or any of Grand Slam’s agents/employees, for any injuries that may be sustained as a result of participating in this training program. As well, all information contained herein is true and accurate. Further, in the event Grand Slam is asked to participate in any of the following, my child may participate in all television filming, newspaper interviews, movies, film commercials and questionnaires. I have no objection to my child being included in photographs, slides or movies taken during the tour which might be used for purposes of interpreting, marketing, promoting and publicizing Grand Slam or this clinic session.
APPLICANT’S SIGNATURE: DATE:
PARENTS SIGNATURE: _____________________________________________________ DATE:_____________
(If child is under 18 years old)
Cancellation and Reimbursement Criteria’s
All cancellations must be received in writing by Grand Slam. According to the date of the cancellation, the following schedule of refunds/fees will apply:
- 31 or more days prior to start of program/clinic, a full refund will be made.
- 30-15 days prior to start of program/clinic, a 60% of the total cost is refundable.
- 14-01days prior to start of program/clinic a 40% of the total cost is refundable.
- Participants canceling on the day of or later will be subject to 100% forfeiture of all funds paid.
- No refund will be made for any unused portions of any program unless such portion has been deleted from the schedule, or said program has been cancelled.
PARENT INITIAL
______ I have read the cancellation policy and understand my responsibility.
PAYMENT MUST ACCOMPANY EACH APPLICATION OR GROUPS OF APPLICATIONS.
MAKE CHECKS PAYABLE TO: “GRAND SLAM” and SEND TO:
Grand Slam Sports, 150 Colonial Road, Manchester, CT 06040
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DC:____ PC:____ DATE:____________ NO.:_______
Credit Card: ( MC / Visa ) Credit Card Holders Name:__________________________________________________
Credit Card No.:____________________________________________________ Exp. Date:_____________________
Credit Card Holders Signature:__________________________________________________
Grand Slam
Permission / Waiver Form
This is a request for permission to use any photos of your child on the official Grand Slam web page on the internet. Images are used on the internet to promote Grand Slam, however, the use of images is strictly controlled to best assure child safety and confidentiality. Children whose images are displayed on the internet will be identified only by first name, not family name, if at all.
Please return this form to indicate that your child's picture may be used on the internet. This permission will stay in effect until cancelled by the parent or guardian.
Thank you for your cooperation.
As the parent or legal guardian, I grant Grand Slam USA the permission to use my child's picture on the facilities web page named above on the internet.
_____________________________________
Child's Name
_____________________________________
Parent or Legal Guardian's Signature
__________________
Date Signed
Grand Slam
Medical Release Form
FULL LEGAL NAME: _________________________________________________________________
ADDRESS: ___________________________________________________________________________
CITY: _____________________________________________ STATE: _______ ZIP: _______________
PHONE: (______) _____________________ EMERGENCY PHONE: (______)____________________
EMAIL ADDRESS: _______________________________________ BIRTHDATE: ________________
MM/DD/YY
Are you presently covered by health and accident insurance? _____YES _____NO
Insurance Company:________________________________________________
Insurance No.:_____________________________________________________
Please list below any medical problems concerning your child that we should be aware of:
I know that my participation in Grand Slam sports activities is potentially hazardous and can cause bodily injury or death. I clearly understand that by signing this form and or my involvement in Grand Slam sports activiites, I assume all risk for any injury resulting there from. I also give permission to allow emergency medical attention as needed.
_______________________________________________
Child's Signature (if over 18)
_____________________________________
Parent or Legal Guardian's Signature
__________________
Date Signed
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