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Genesis Baseball Academy Registration

Genesis Baseball Players new member, contact, and general information form.

"*" indicates required fields

Child's Name*

Date of Birth*

MM slash DD slash YYYY

Age

Parent's Name*

Parent's Phone*

Email*

Emergency Contact Name*

Emergency Contact Phone*

Family Doctor

Session Dates

Method of Payment

Home Address*

Street Address City State / Province / Region ZIP / Postal Code

Waiver and Release*

I agree to the Participation Policy

I, as a parent / legal guardian of the participant listed above, by signing this enrollment form, waive and release Genesis Baseball Academy, Valwood Board of Trustees, Valwood School, Valwood Facility employees, Professional, Collegiate, and high school Baseball Instructors, from any and all liability from any injury or illness incurred going to Genesis Baseball Academy from home or while at the academy or returning home. I, as a parent / legal guardian have actual knowledge and appreciation for the particulars of the sport of baseball and hereby voluntarily consent to said minors' participation, and assume the risk arising there from. I attest thst the child I am registering has been cleared by a medical doctor for participation in said academy and / or the physical activities that the academy involves. I hereby give my permission for emergency medical treatment in the event I cannot be reached. I understand that the academy supervision starts at listed advertised time to listed advertised completion.

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