Winter 2022 Clinic

Winter Clinic will be held at Keystone Fieldhouse. Clinic runs every Monday evening, starting on January 10th, 2022 for 12 consecutive weeks. Final session concluding on Monday, March 28, 2022. Session is 1 hour from 5pm – 6pm.

Registration Fee for Clinic – $35 for all 12 Weeks or $5 per session

Any questions or concerns, please email [email protected]. Thank you for your registration!

Player First Name*

Player Last Name*

Street Address1*

Street Address2

City*

Postcode / Zip*

Grade*

Birthdate*

Parent/Guardian Info

Parent/Guardian #1

Parents First Name (Primary)*

Parents Last Name (Primary)*

Primary Email*

Home Phone*

Cell Phone*

Medical/Emergency Contact Information

Any known allergies and/or medical conditions? If so please list them below.*

Emergency Contact Name*

Emergency Contact Phone*

Relationship to Player*

Insurance Carrier*

Policy Number*

Consent Agreement

I/We, the parent/guardian of the above-named player, hereby give my approval to their participation in any league activities during the current season. I assume all risks and hazards incidental to such activities, and hereby waive, release, absolve, indemnify, and agree to hold harmless the South Middleton Youth Softball Association, the Board of Directors, sponsors, coaches, participants and persons transporting my child to and from SMYSA activities, for any claim arising of any injury to my child except to the extent and in the amount covered by accidental and liability insurance. I further give my permission for the SMYSA to use my child’s likeness and/or name in any publication related to the activities of the League.

Before completing your registration form please read through our Privacy Policy page

Consent Agree Checkbox*

Agree

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Payment Information

12 Week Clinic Price – $35.00
Every Monday at 6pm from January 10^th -March 28^th, 2022

Individual Session Price – $5.00
If you would like to pay per session, the cost is $5.00 per session. Payment can be brought to individual sessions of attendance.

Remit Payment to:
South Middleton Youth Softball/Ron Snow
220 Berkshire Drive
Carlisle, Pa 17015

Please send an email to [email protected] to indicate your preference of attendance.

We look forward to seeing you and the girls on January 10^th!

SMYSA Board

Winter 2022 Clinic