Registration - Baseball Youth Camp

-June: 23rd-26th OR August: 4th-7th
-9-12 pm
-Age: 7-12 years old
-GPS Address: 4260 W. Roy Furman Highway, Waynesburg, Pa., 15370

Please choose a Camp date:

Please choose a Camp date: June 23 - 26, 2025 August 4 - 7, 2025
Student Name: Student Name: First Last
Date of Birth: Date of Birth: / MM / DD YYYY
Current Age:
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Primary Phone: Primary Phone: - ### - ### ####
Parent/Guardian Email:
School District:
Current Grade Level
Emergency Contact Name #1 Emergency Contact Name #1 First Last
Relationship
Phone Number 1 Phone Number 1 - ### - ### ####
Emergency Contact #2 Emergency Contact #2 First Last
Relationship
Phone Number 2 Phone Number 2 - ### - ### ####
Insurance Company
Policy Holder Name
Policy Number