2022 Clovis Unified Winter Baseball Camp at Clovis West

Date: January 29, 2022 Time: 9:00 a.m. – 12:00 p.m. Ages: 8-12
Location: Stan Bledsoe Field (Clovis West High School) Cost: $ 40 (T-shirt and Lunch Provided)
Checks payable to: CCSRD

Mail to: Clovis West High School Attn: Kevin Patrick
1070 E. Teague Ave, Fresno CA, 93720

Participant Info:

First Name:	

Date of Birth: 	

Last Name: 	

School Enrollment2021-22 	

T- Shirt Size ___________ (Specify youth or adult size)

Parent/ Guardian	E-mail	

Address	Cell Phone: 	

Emergency Contact: 	

Phone: 	

Alternate Phone: 	

Relationship:	

Alternate Phone: 	

Astheparent/guardianoftheabove-namedchildandonbehalfofmyselfandmychild,agents,heirs,and successors,I voluntarily agree to: (1) assume all risks of injury, illness, or death to my child arising out of or resulting from my child’s participation in and/or attendance at the above-stated program or activity, such risks to include but are not limitedto,injury,illness,ordeathduetobeingexposedtoorinfectedbycontagiousdiseases,includingCOVID-19;(2) waiveandreleaseallclaims,causesofactions,actions,liabilities,andcostsagainsttheClovisUnifiedSchoolDistrict (District)anditsgoverningboardandmembersthereof,officers,employees,agents,andvolunteers(collectivelyDistrict Personnel)andholdharmlesstheDistrictandDistrictPersonnelfromanyclaims,causesofactions,actions,liabilities, andcoststhatmayariseoutoforresultfrommychild’sparticipationinorattendanceatsuchprogramoractivity;and
(3)assumeallobligationsforany medical,financial,andothercostsand/orliabilitiesthat besustained orincurredby mychild,myself,ormyagents,heirs,and/orsuccessors.TheDistrictassumesnoresponsibilityandshallnotbeliable foranyinjury,illness,death,liabilities,damages,orcoststhatmychild,myself,myagents,heirs,and/orsuccessorsmay sustain or incur arising out of or resulting from the aforementioned program or activity.

In accordance with CIF bylaw 207, any athlete who transfers from School “A” to School “B” after having prior contact, during the previous 24 months, either directly or indirectly with school “B” prior to enrollment shall not be eligible at School “B” for 365 days from initial date of enrollment. This includes this camp, clinic, AAU, club team, and/or workouts.

Parent/Guardian Signature: 	 Date: 	

Every participant must have a signed form turned in prior to participating in any activity.