CAMP DATES: JULY 21 25, 2013 8:30a.m. 4:00p.m.

Laker Baseball Field

Summer 2013 Finger Lakes Community College Baseball Camp

CAMP DESCRIPTION Join Finger Lakes Community College Head Baseball Coach Sean Marren for a week of skills and drills. Campers will work on the fundamentals, but will also participate in several contests and games! CAMP COSTS $225 One Camper $195 Group of Four [or more] $165 Group of Eight [or more] $135 Group of Ten [or more] Checks Payable: FLCC Association

Contact Alex Pagliano to receive the group discount. CAMPER INFORMATION Name: ________________________________ Address: ________________________________ City: ___________________ State: _____ Zip Code: _________ Phone Number: ________________________ Email Address: ____________________________________________ School: _______________________________ Grade: ________ EMERGENCY INFORMATION Please list any physical conditions that Finger Lakes Community College should be aware of in case of an emergency: ____________ _________________________________________________________ Emergency Contact (1) Name: _______________________________ Emergency Contact Phone Number: __________________________ Family Physician: _________________________________________ Family Physician Office Number: _____________________________ **Attached to this form, please affix a copy of your childs immunization record and health insurance card. CONSENT TO ATTEND *In the event that I am unavailable for the purposes of providing parental consent, I certify that Finger Lakes Community College (hereby referred to as FLCC) camp staff to seek appropriate medical treatment [physician, camp health staff, etc.] for incurred injuries as necessary. *I understand that FLCC does not provide medical insurance for campers and that in the event of injury, our family medical insurance must be used to cover the cost of care. *I agree to assume full responsibility for any damages to property as a result of my childs actions while at camp. I further agree to pay for said damages. *I hereby waive and release FLCC from any and all liability for any injuries incurred by my child while at camp. ______________________________ __________ Parent/Guardian Signature Date

CONCERNS OR QUESTIONS? Contact: Alex Pagliano Phone: (585) 785-1538 Email: pagliaar@flcc.edu SEND COMPLETED FORMS TO: Finger Lakes Community College ATTN: Alex Pagliano, Athletics 3325 Marvin Sands Drive Canandaigua, N.Y. 14424