Registration Form for the Elite Pitchers Boot Camp

“Quick Action Registration 2013

Ron Wolforth’s Texas Baseball Ranch

Elite Pitchers’ Boot Camp”

_____ Yes, Sign me up! I’m anxious to come to Houston and train with Coach Wolforth, the ranch staff, and other motivated pitchers from around the country.

Athlete’s Name: __Today’s Date//_

Athlete’s Birthday: _____/_____/____ How you heard about the camp:______

Address: ______T-Shirt Size: ______

City: ______State: ______Zip: ______

Day Phone: ______Eve. Phone: ______

Fax: ______E-mail: ______

Please check the camp you’re attending and package (if applicable):

□ June 7-9 (Fri-Sun) - $749□ July 26-28 (Fri-Sun) - $749

□ June 14-16 (Fri-Sun) - $749□ August 16-18 (Fri-Sun) - $749

□ July 12-14 (Fri-Sun) - $749□ Aug. 31- Sept 2 (Sat-Mon) - $749

I would like to attend an additional camp(s) over the next year / two and I am

taking advantage of the discount checked below:

□ Package A - 2 Boot Camps at $1399

□ Package B - 3 Boot Camps at $1949

□ Package C - 4 Boot Camps at $2399

Cancellations: A FULL refund will be made for any cancellation received 1 month prior to the start of your scheduled camp. A 50% refund will be applied for cancellations made 14 days prior to your camp. There are no refunds if the cancellation occurs within two weeks of your scheduled camp. You can apply your fee to any session with spaces still available at full credit; however any changes made within 14 days of the camp will incura $200 change fee.

Method of Payment

□ I am enclosing a check in the amount of $ ______made payable to:

PITCHING CENTRAL, 5451 Honea-Egypt Rd, Montgomery, TX 77316 (936) 588-6762

□ Please charge my credit card $ ______

□ I would prefer to have my payment divided into 2 equal monthly payments of $ ______

Signature (Required) ______Date ______

Credit Card (circle one): VISA MASTERCARD DISCOVER AM EXPRESS

Card Number: ______Expiration Date: ______Auth Code

Name on credit card (if different from above): ______

Billing Address for credit card (if different from above): ______

______

I’m anxious to get registered and secure my spot immediately!

So I’m FAXING my registration to: (281) 298-7391.

Ron Wolforths Texas Baseball Ranch LLC and/or Pitching Central

Waiver And Release Of Liability

In consideration of being allowed to participate in any way in the Ron Wolforths Texas Baseball Ranch LLC and/or Pitching Central athletic program, related events, and activities, undersigned acknowledges, appreciates, and agrees that:

The risk of injury from the activities in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist, and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, or others, and assume full responsibility for my participation, and,

I willingly agree to comply with stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately, and,

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Ron Wolforths Texas Baseball Ranch LLC/Pitching Central their officers, members, official agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the event (“Release”), WITH REPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss of or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

X______Date Signed:______

PARTICIPANT SIGNATURE

PRINT NAME

FOR PARTICIPANT OF MINORITY AGE

(UNDER AGE 18 AT THE TIME OF REGISTRATION)

THIS IS TO CERTIFY THAT I, PARENT/GUARDIAN WITH LEGAL REPONSIBILITY FOR THIS PARTICIPANT, DO CONSENT AND AGREE TO HIS/HER RELEASE AS PROVIDED ABOVE OF ALL THE RELEASES, AND FOR MYSELF, MY HEIRS, ASSIGNS, AND NEXT OF KIN, I RELEASE AND AGREE TO INDEMNIFY THE RELEASEES FROM ANY AND ALL LIABILITIES INCIDENT TO MY MINOR CHILD’S INVOLVEMENT OF PARTICIPATION IN THESE PROGRAMS AS PROVIDED ABOVE, EVEN IF ARISING FROM THEIR NEGLIGENCE.