Danville Dans Program 2022 | Page 11

2022 DANVILLE DANS Official Program 11

Name ___________________________________ Grade ______ Pos _______ Name ___________________________________ Grade ______ Pos _______ Name ___________________________________ Grade ______ Pos _______ Address - inc . City & ZIP ________________________________________________ Parent ’ s Cell Phone _________________________________________ Email _____________________________________________________

First Child

Add ’ l Camps Check each that apply Add ’ l Children Add ’ l Camps

Tues-Wed , June 28-29 $ 80 $ 70 $ 70 each $ 60 each Mon-Tues , July 11-12 $ 80 $ 70 $ 70 each $ 60 each

Total Due $_____________

Scan QR code to make payment through Paypal . Email this form to : coleman21 @ hotmail . com Or mail form and check ( payable to Eric Coleman ) to :

Danville Dans – 138 E Raymond – Danville , IL 61832

Questions : email coleman21 @ hotmail . com or call 702-994-5040

Parental Permission for : ________________________________________

( name of child / children )

has my permission to participate fully in the Danville Dans Baseball Camps . I authorize the staff of the Danville Dans Baseball Camps to act for me in the event of any emergency . I hold harmless the staff of the Danville Dans Baseball Camps for all liability and responsibility for any injury incurred as a result of participation in camp . I understand that I am responsible for primary insurance coverage of my child .

__________________________________________________________________________________ Signature of Parent or Guardian