| 6th Annual Summer Camp
2010 Camp Dates and Locations
Session 1: Monday, July 5 – Friday, July 9
Marlboro Little League 9:00am - 2:30pm
Session 2: Monday, July 12 – Friday, July 16
Marlboro Little League 9:00am - 2:30pm
Session 3: Monday, July 19 – Friday, July 23
Marlboro Little League 9:00am - 2:30pm
Session 4: Monday, July 26 – Friday, July 30
Old Bridge Little League 9:00am - 2:30pm
Session 5: Monday, August 2 – Friday, August 6
South Wall Little League 9:00am - 2:30pm
Camp Times
Ø All full day camp sessions will take place from 9:00am - 2:30pm. Full day camp price is $250 per session.
Ø Half day camps are available from 9:00am - 12:00pm for $150 per session.
Age Groups
Children will be grouped by age and ability. Groups are: 5-6, 7-9, 10-12. 13-16
Please fill out and return this form to Jason Faigin at P.O. Box 121, Marlboro, NJ 07746. If you would like to pay in full, include a check payable to J. Faigin’s Baseball Academy, LLC. A deposit of $100 per child and per session is necessary to reserve a space for your child. If your child is unable to attend, a credit for future academy session will be provided. Payment is non-refundable.
Please be sure to print and complete all information below.
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Child’s Name Session(s) Attending
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Parent’s Name
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Street Address
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City State Zip
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Phone #1
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Phone #2
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Birth date (mo/day/year) Grade
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E-Mail
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Name of Emergency Contact
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Emergency Contact #
RELEASE, WAIVER, AND CONSENT FORM
J. FAIGIN’S BASEBALL ACADEMY, LLC
I am the parent/legal guardian of ________________________ who is, with my permission, a “Participant” in J. Faigin’s Baseball Academy, LLC (“JFBA”).
I represent that Participant is emotionally ready, in good health, and is given my permission to participate in this program. I understand that there is some risk in playing baseball and baseball related activities and I am willing to assume those risks. I represent that Participant has no ailments or disabilities that would prevent Participant from participating in JFBA activities.
As lawful consideration for participating in JFBA activities, I hereby release from any legal liability JFBA and all of its officers, directors, members, agents, and employees for any and all property damage, personal injury or death caused by or resulting from Participant’s participation in JFBA activities, whether or not such property damage, personal injury or death was caused by or resulted from their negligence or any other cause.
I further agree not to sue, claim against, attach the property of, or prosecute JFBA or any of its officers, directors, members, agents, or employees for any property damage, personal injury or death caused by or resulting from Participant’s participation in JFBA activities, whether or not such property damage, personal injury or death was caused by or resulted from their negligence or any other cause.
I further agree to defend, indemnify, and hold harmless JFBA and all of its officers, directors, members, agents, and employees for any property damage, personal injury or death caused by or resulting from Participant’s participation in JFBA, whether or not such property damage, personal injury or death was caused by or resulted from their negligence or any other cause.
In case of emergency, I grant my permission to have Participant given emergency treatment at a local hospital. I understand and agree that I am responsible for all medical care expenses incurred to treat the Participant’s injuries including, without limitation, physician, hospital, lab, drug, and device expenses. I also grant permission for any photographs taken of my child in the program to be used for future promotional use.
I have carefully read the above and fully understand its content. I am aware that I am releasing certain legal rights that I may have, and I enter into this Release of my own free will.
Signature: ________________________
Name: ___________________________
Address: _________________________
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Date: _____/_____/______
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