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Please print and mail this form to: Richmond Baseball Academy West, 5904 School Ave., Richmond, VA 23228 along with a $50.00 nonrefundable deposit to insure registration in the program of your choice. Checks, Visa and Mastercard are accepted. Please make checks payable to RBA West.
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Name_________________________________DOB___________
Address_______________________________________________
City__________________________State_______Zip__________
Phone__________________Emergency Phone_______________
Email Address:_________________________________________
Complimentary T-Shirts will be handed out the last day of camp.
Circle Size: YS, YM, YL, AS, AM, AL, AXL
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Players are to attend 1 class per week specific to their age group.
Please Circle the Program you wish to attend:
Richmond (Staples Mill) Programs:
WS-1, WS-2, WS-3, WS-4, WS-5, WS-6
Rockville Programs:
WR-1, WR-2, WR-3, WR-4, WR-5
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I approve of my son/daughter's attendance at Richmond Baseball Academy West and certify that he or she is in good health and able to participate in all camp activities. I recognize the possibility of an accident, injury or sickness and I agree RBA West personnel have my permission to use their best judgement in the care of my child and not hold RBA West liable if injury occurs.
Parent or Legal Guardian Signature_______________________________________________________Date____________
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Credit Card Information: ______Visa _____ Mastercard
Name on Card____________________________________________________
Number___________________________(3 Digits on Back)__________Exp._____________
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Winter Camp Cost:
$275.00
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