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Spring Break Camp Application

This online application must be completed for each camper. Please fill in the appropriate information and choose the number of children and additional siblings for each age group. Once you submit the form you will be presented with a button to pay the camp fees. Registration is NOT complete until the payment is processed. You will receive separate confirmation emails from the camp and PayPal. Save your confirmation emails for your records.

"I guarantee your complete satisfaction. If you are not satsified with the quality of Home Run Baseball Camp, I will refund your money. Cancellations within a month of registered week will be offered credit." - John McCarthy

Camper Info
  Child's Name (First) / (Last): Date of Birth:
First Child: / /
4 y/o must register for half day below
Half Day Option? Check here to register camper for half day (child must be 4 - 7 years old)
Medical conditions/allergies?
  SKIP THIS SECTION IF YOU ARE ONLY REGISTERING ONE CHILD
Additional Sibling: / /
4 y/o must register for half day below
Half Day Option? Check here to register camper for half day (child must be 4 - 7 years old)
Medical conditions/allergies?
  SKIP THIS SECTION IF YOU ARE ONLY REGISTERING TWO CHILDREN
Additional Sibling: / /
4 y/o must register for half day below
Half Day Option? Check here to register camper for half day (child must be 4 - 6 years old)
Medical conditions/allergies?

Parent Info
Parent Name: (First, Last)   Cell:
Email Address: Home/Work:
Alternate Contact: Cell:
    Home/Work:
Address:    
City, State, Zip    
Doctor: Phone:
Hospital:

Session Info

There is only one session for this camp: March 29 - April 2, 2010

Read Terms and Continue to Payment Processing

By submitting this form you agree to the following:
My child has had an athletic physical within the year and has my permission to attend Home Run Baseball Camp. In case of an accident or any medical emergency, and if I, my spouse or emergency contacts cannot be located, I authorize the staff to call my child's physician to arrange for medical and/or surgical care. I understand that the staff of HRBC cannot be responsible for accidents.

Choose Payment Option

Please choose your payment option below:

PayPal - Use the "Pay Now" button on the next screen and complete your camper sign-up

Check - Mail a check to camp. Registration not complete until payment is received.

To combat SPAM, please enter the value of (2 + 3) =

PLEASE CLICK JUST ONCE