Western Mustangs U11-U13 Pitching Clinic Registration (Dutton Royals)

Western Mustangs U11-U13 Pitching Clinic Registration

Please use this form to register for the U11 - U13 Western Girls Pitching Clinic on Sunday April 12th.

This form has a limit of 20 submissions. At the moment this page loaded, 15 submissions have been submitted. It is possible that not all submissions have been validated at this time, and more openings could become available. However, at this time only 5 more submissions will be accepted.

Player Information

Please provide the following information about your player.

Player Name^*

Required

First and Last Name

Player Birthdate^*

Required

Has your child pitched in a game before?^*

YesNo

Required

If yes, what age level did your child last pitch for?^*

Required

Please include the location, and age group. Information will be provided to the clinic instructors to prepare the session appropriately.

Has your child received formal pitching training or pitching skills sessions?^*

YesNo

Required

If yes, please provide some additional training. E.g. How many sessions, who provided the training etc. This information will be provided to the instructors so they can plan the sessions appropriately. ^*

Required

E.g. "My child has completed the CanPitch Clinics or my child completed three (3) sessions with Name of Private Instructor."

Emergency & Medical Information

Please complete the following emergency & medical information.

Parent 1 Full Name^*

Required

Parent 1 Email^*

Required

This email will be used for primary communication.

Parent 1 Phone Number^*

Required

Example: ###-###-####

Parent 2 Name

Parent 2 Email:

This email will be included on all outgoing email correspondence.

Parent 2 Phone Number:

Emergency Contact 1 Name^*

Required

Emergency Contact 1 Phone Number^*

Required

Emergency Contact 1 Relationship to Player^*

Required

Emergency Contact 2 Name^*

Required

Emergency Contact 2 Phone Number^*

Required

Emergency Contact 2 Relationship to Player^*

Required

Medical Information:^*

Required

Please include any medical information you wish to disclose. If none - put "N/A."

Please review the following information:

Registration is not secured until payment has been made.
Registration fees are non-refundable. Registration fees will not be returned if your player is unable to attend.
Parents are required to ensure they are present to pick up their player at the end of the session. If the individuals picking up your players are not one of your contacts listed, you must notify us so we are aware who will be picking up your player.
All players/parents/and coaches are expected to follow the Dutton/Dunwich Minor Ball Code of Conduct. Any violations will be forwarded to the Board for review.

I agree to the terms and conditions stated above^*

Photo Release
Photos of player may be taken during the skills for use by Dutton/Dunwich Minor Ball online and in promotions of upcoming girls-only skills events. Names and other identifying individual information will not be shared.

If you wish to not have your child photographed, you must email [email protected] to request. If you do not make an individual request, your acknowledgement of this release is you giving permission for the photos to be taken/used as mentioned above, unless you submit an individual request.

I understand that if I wish for my child not to be photographed it is my responsibility to individually contact the Secretary as mentioned above. ^*

Registration Fee
The registration fee of $10 due to hold your child's spot in the clinic. No refunds.

The registration fee must be paid in order to secure your spot. There are limited spots available.

Registration fees must be sent via e-transfer to [email protected] Please include "Western Pitching Clinic" in the notes/memo.

I agree to submit payment to secure my registration and understand there are no refunds or partial registration fees. ^*

Western Mustangs U11-U13 Pitching Clinic Registration (Dutton Royals)

Player Information

Emergency & Medical Information

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