Please print then complete this two part FORM

1) Registration Form

Name of Participant:

Date of Birth:

Address/City/State/ZIP:

Parent/Guardian Name:

Parent/Guardian Phone (Home):

Parent/Guardian Phone (Work):

Camp Name:

Week Date:

Make Checks Payable To: Rhinehart Baseball Inc.

Please Read and Sign the Medical Consent Form

2) Medical Consent Form

I hereby state that my child is in good normal health, and has my permission to participate in all school activities.  In addition, I authorize the R.B.I staff to act for me in the event of injury or sickness.  A registration requires that a parent/guardian sign below to agree that in case of accident while attending R.B.I training, they release the School, the Ownership, the Counselors and the Directors from any and all liability. Each Child is required to carry personal medical insurance coverage.

Date:

Signature:

Mail this Form and Check to:

RHINEHART BASEBALL, INC

7285 Joffa Circle
Warrenton Va. 20187    

Phone (703) 577-1810