The clinic consists of 6 sessions, each 75 minutes, on the following Sundays: Jan 3, Jan 10, Jan 17, Jan 24, Jan 31, and Feb 7. (Note: Feb 21 and Feb 28 will be reserved as "make up" sessions, if needed) Registrants will be added to the clinic roster once payment is received. Please submit prompt payment as spaces are limited. All proceeds from the Nazareth Softball Winter Youth Clinic help offset costs for the high school players' trip to Myrtle Beach for spring training. Thank you for your support!

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1. Athlete's Name? (Required.)

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2. Athlete's age as of January 1, 2027 -- (Required.)

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3. Athlete's Home Address (Required.)

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4. Parent/Guardian's Name (Required.)

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5. Parent/Guardian's Phone Number? (Required.)

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7. Emergency Contact Name? (Required.)

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8. What is the emergency contact's relationship to the athlete? (Required.)

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9. Emergency Contact Phone Number? (Required.)

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10. Shirt Size? (Required.)

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11. Please indicate your method of payment for the fee of $150.

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12. I hereby certify that I am the legal guardian of the above named student athlete, and they are in good health and able to participate in all activities associated with the clinic. If emergency medical attention is required, I authorize medical treatment at my expense. Please type your full name to acknowledge: (Required.)

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13. During the clinic, photographs may be taken to celebrate the program and promote the partnership between the Nazareth Softball Booster Club and community-based youth softball. These images may be shared on the Nazareth Team and Booster Club's social media pages and other Booster Club communications.

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14. Medical Insurance Company:

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15. Medical Insurance Policy Number:

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16. Name of Insured:

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17. Any medical concerns the coaches should be aware of?

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