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Printable MS Word Version To Mail

Coast to Coast Baseball

Player Registration Form

FULL LEGAL NAME: ______________________________

ADDRESS: _________________________________________________________

CITY: _____________________________________________

STATE: _______ ZIP: _______________

PHONE: (______) _____________________

EMERGENCY PHONE: (______)____________________

EMAIL ADDRESS: _________________________________________________

WAIST SIZE (in inches): __________

SHIRT SIZE (youth L, or adult S, M, L, XL, XXL): ___________

BIRTHDATE: _____________

PRIMARY POSITION: ________

SECONDARY POSITION: ________
                           MM/DD/YY

Please send me information on the
Booster (Parent) Travel Program
(check if interested):         _______

Please indicate your choice by placing an “X” next to the trip.
If you wish to register for more than one trip you must make a
separate deposit for each trip.

Trip                                       Dates                                 Ages                Choice

Showcase       Dec. 27 – Dec. 31          (2006)                    15-18               ______
Puerto Rico     Feb. 5 – Feb. 11            (2007)                    16-18               ______ 
Puerto Rico     Apr. 1 – Apr. 7               (2007)                    11-12               ______
Puerto Rico     Jun. 17 – Jun. 23           (2007)                    16-18               ______                 
Puerto Rico     Jun. 25 – Jul. 1              (2007)                    13-15              ______ 
Japan             Jun. 26 – Jul. 8               (2007)                    16-18              ______
Australia         Jul. 3 – Jul. 16                (2007)                    16-18             ______                 
Hawaii            Jul. 30 – Aug. 6              (2007)                    16-18             ______
                                                                                                                                                                               
I have read and approved the code of conduct, itinerary, tour price, payment schedule,
responsibility and cancellation clauses as they appear in the Coast to Coast Amateur
Athletics, Inc
. acceptance package. I further agree to hold Coast to Coast Amateur
Athletics, Inc.
free from liability due to injury suffered during tour competition and
will furnish documentation showing full insurance against injury (medical). Further,
in the event Coast to Coast Amateur Athletics, Inc. 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 or video taken during the tour which might
be used for purposes of interpreting, marketing, promoting and publicizing Coast
to Coast Amateur Athletics, Inc.
or this particular tour.

CHECK ONE

 

______                  REGISTRATION DEPOSIT ENCLOSED: Non-refundable registration fee
(checks payable to “Coast to Coast Baseball”)
______                  REGISTRATION PAYMENT MADE ONLINE.
                                               

Online Confirmation number:  ___________________________________

______                  REGISTRATION FAX (Use Credit Card Authorization Form).

PLAYER SIGNATURE: ___________________________________

DATE: ___________________

PARENT SIGNATURE: ___________________________________

DATE: ___________________



Coast to Coast Amateur Athletics * P.O. Box 389 * Marietta, OH 45750
PHONE 928-854-9455 * FAX 928-854-6669

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