HIT ONE DEEP 2010 SUMMER ENROLLMENT FORM

Name:
Age
D.O.B.
Address
ZIP Code
City
Home Phone
Emergency Phone
League
Level
Any Medical Conditions
T-Shirt Size Adult Sm
Adult Med
Adult Lg
Adult XL
Please Mark Appropriate Camp Session #1 June 21st-25th
Session #2 July 19th-23rd
Session #3 July 26th-30th
Session #4 Aug 16th-20th
Camp Cost: $225 ($40 Deposit Required)
Form of Payment: (Check/Cash/MasterCard/Visa)
Card # (Please Type N/A if paying with Check or Cash)
Exp. (Please Type N/A if paying with Check or Cash)
Customer (Print)
Signature

AGREEMENT AND RELEASE OF LIABILITY

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