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Nashua Baseball Academy, LLC, Registration Form
Name________________________
Address_____________________
Telephone____________________
E-mail_______________________
Age___ Date of Birth__/__/__
Height__________Weight_______
Baseball Experience
Please list the baseball experience and levels the Athlete has recently experieced including school teams, Spring seasons, All Stars, AAU affiliation, Fall programs and positions played.___________________________________________________
Waiver Authorization Emergency Medical Treatment Form
I certify that my child, _____________________________, is in good health and may participate in the Nashua Baseball Academy. I acknowledge that the activities at the Academy include risks of personal injury and do hereby waive any claims or potential claims for injuries against the Nashua Baseball Academy, LLC, it's emp[loyees, owners, landlords, members or volunteers. It is understood that the Nashua Baseball Academy, LLC, it's owners, members, landlord, volunteers, employees, or anyone associated with it's programs are not responsible for accidents resulting in medical, dental, or other expenses.
In case of emergency, I grant permission for my child to be given emergency medical treatment at a local hospital. I understand this authorization will only be enforced when I cannot be contacted and/or cannot provide for immediate treatment.
Date:________________________Parent or Guardian___________
Insurance Company____________
Policy #_____________________
Physican_____________________
Hospital_____________________
Emergency #__________________
Cell Phone#__________________
Tuition and Fees
Tuition to the Nashua Baseball Academy is $300 per session. The fee is due 2 weeks prior to the first class.
The Nashua Baseball Academy will accept applications on a first come first served basis. Space is limited. Members in previous classes will be guaranteed a spot in future classes.
Calendar and Off Days
The Academy will be closed occasionally for staff personal days and staff clinics. Please refer to the specific Calendar for that session to be sure of accurate open dates.
Remit applications to;
Nashua Baseball Academy
c/o Rich Loftus
4 Dartmouth St.
Nashua, NH, 03064
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