CLINIC summer 2014 REGISTRATION
Questions marked by * are required.
1.	Division: * Birth Years 2005 & above
2.	Are you new to VMBA ? *
3.	Last League that you played in : *
4.	Family Last Name *
5.	Player's Name *
6.	Address: *
7.	City : *
8.	Postal Code: *
9.	Sumitter Email: *
10.	Date of Birth ( YYYY-MM_DD) *
11.	Home Phone Number *
12.	Mother's / Guardian Cell Phone:
13.	Dad's / Guardian Cell Phone:
14.	Any Medical Concerns ? *
15.	Mother's /Guardian Name *
16.	Father's / Guardian Name *
17.	Emergency Contact *
18.	Emergency Phone Number *
19.	Wavier of Liability * I ACCEPT AS THE PARENT/GUARDIAN OF THE ABOVE NAMED PLAYER, I DO HEREBY GIVE MY APPROVAL FOR MY CHILD TO PARTICIPATE IN ANY AND ALL BASEBALL ACTIVITIES FOR THE CURRENT SEASON. I ASSUME ALL RICKS AND HAZARDS INCIDENTAL TO HIS/HER PARTICIPATION AND I WILL AGREE TO WAIVE, RELEASE, ABSOLVE AND PROMISE TO INDEMNIFY AND SAVE HARMLESS THE VANCOUVER MINOR BASEBALL ASSOCIATION, ITS OFFICERS,MANAGERS,COACHES,UMPIRES,PARTICIPANTS AND PERSONS TRANSPORTING MY CHILD FROM ANY AND ALL LIABILITY, INCLUDING NEGLIGENCE. I have read the waiver of liability and agree. If you don not agree, you cannot submit this form: Please check : I ACCEPT
20.	Registered By:( Must be a legal guardian) *
21.	TERMS: * I AGREE TO THE ABOVE TERMS,Please be advised that the submission of this registration form does not guarantee a spot in our Winter Clinic program. Please bring full payment to your first Winter Clinic . Space is limited.