ELITE FASTPITCH INC.

12 Mallard Drive Office- 609-268-9754

Tabernacle, NJ 08088

E-mail- elitefp@aol.com

General Registration Form

Course or service-

Location-

Time-

Level (If any)-

Name (first)-

Name (Last)-

Street-

Town-

State-

Zip-

Parent Personal e-mail address-

Parent Work e-mail address-

HS Year of HS Graduation (must)-

School-

Home phone-

Work phone-

Age-

DOB-

Prim. Pos-

Alt. Pos-

NO STUDENT WILL BE PERMITTED TO PARTICIPATE WITHOUT A SIGNED ELITE
FASTPITCH INC RELEASE FORM. THERE WILL BE NO EXCEPTION. PRINT THIS FORM FROM OUR WEB SITE.

Medical Insurance Co. __________________________________

Policy #______________________________________________

Payment Information

1. We anticipate a space problem at most locations throughout the school year, to help us schedule, send a $30.00 deposit check to hold space immediately.

2. The balance is due at the first class. If late, add $5.00 per week late.

3. You are purchasing instruction as scheduled by Elite Fastpitch. It is understood that it is your responsibility to attend. Make up classes are not guaranteed but are possible if approved prior to class.

4. All students (W1, W2, W3 & C1) are required to purchase (one time only) the DVD of their level. Cost of DVD is $25.00 each. Other levels are optional.

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