Extra Bases 2011 Summer Camp Registration

Step 1:

Please fill out the registration form below and then choose the weeks and/or days for which you would like to register your children.

Fields marked with an ( * ) are required.

Camper Info

  Child's Name: Date of Birth:
*First Child:
Child's Name (2):
Child's Name (3):
Child's Name (4):
Please note any medical
conditions or allergies:

Parent Info

*Parent Name: *Cell:
xxx-xxx-xxxx
*Email Address: *Work:
Parent Name: Cell:
    Work:
*Alternate Contact: *Cell:
    *Work:
*Address:
*City,
State,
Zip

Step 2: 2011 Schedule & Pricing

Tuition:

  • Day Rate: $75 per day
  • Week Rate: $300 per week
  • 10 Day Package: $650
  • 3-week Package: $750

Instructions:

  1. Choose the weeks and/or days you would like to register your child(ren) for by checking the box next to the appropriate session.
  2. If you register for a week, you cannot register for any of the individual days within that week.
  3. If you are registering more than one child, each child will be registered for each of the sessions you choose, unless a separate registration form is completed for each.
  4. Refer to the pricing schedule above to determine the cost of each session.

  2011 Summer Schedule
  Week 1
 Week 2
 Week 3
 Week 4
 Week 5
 Week 6
 Week 7
Mon Jun 13 Jun 20 Jul 4 Off Jul 11 Jul 25 Aug 8 Aug 15
Tues Jun 14 Jun 21 Jul 5 Jul 12 Jul 26 Aug 9 Aug 16
Wed Jun 15 Jun 22 Jul 6 Jul 13 Jul 27 Aug 10 Aug 17
Thurs Jun 16 Jun 23 Jul 7 Jul 14 Jul 28 Aug 11 Aug 18
Fri Jun 17 Jun 24 Jul 8 Jul 15 Jul 29 Aug 12 Aug 19

By submitting this form, you agree that: My child has had an athletic physical within the year and has my permission to attend Extra Bases Baseball Camp. In case of an accident or any medical emergency, I authorize the staff to call an ambulance if appropriate. I understand that the staff of the camp cannot be responsible for accidents. Unless otherwise communicated in writing to the camp, I give permission for images of my child to be included on the camp website, brochure or other marketing material.

A completed application form must be on file for every camper. Registration is not complete until the payment process is complete. Your credit card or PayPal statement is your confirmation. Campers who apply for sessions that are full will be notified and may select another session or be placed on a waiting list.

To combat SPAM, please enter the value of (2 + 3) =