Impact Baseball 17U

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Impact Baseball Player Payment Plan

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Email:

PARENT/GUARDIAN MAKING PAYMENT

* Relationship to Player:

* Firstname:

* Lastname:

* EMail:

* Cell Phone:

WAIVER INFORMATION

I/we the parents of the above candidate for Impact Baseball, hereby give approval for participation in any and all Impact Baseball related activities. I understand that although Impact Baseball's program is to provide a safe environment for baseball activity, exercise, training and enjoyment, there is an inherent risk in that participation. The participation in these activities and transportation to games, practices and training may result in personal injury. I do hereby waive, release, absolve, indemnify and agree to hold harmless, Impact Baseball, its coaches, volunteers, sponsors, drivers and participants from any claim arising out of an injury to my/our child whether the result of negligence or for any other cause, except to the extent and in the amount covered by the accident or liability insurance of Impact Baseball.

Failure on my son's or my/our part to abide by team rules and the Player and Parent Contracts could result in suspension, loss of playing time or dismissal from the team. This also includes paying Individual Player Fees in a timely manner. I will be expected to pay these fees on the dates they are due. Failure to do so could result in player suspension up to and including dismissal from the team AND the loss of any previously paid team fees. Dismissal from the team will automatically result in any previous paid player fees becoming non-refundable.

All payments via check should be made out to Impact Baseball.

Payments can be mailed to 7033 Fairhaven Oval, Medina, Ohio 44256 (Attention: Head Coach Ryan Meikle). Checks may also be given to Coach Meikle directly but NOT during practice sessions or games. Thank you for your cooperation.

I/we agree with the above *

* Player Payment Options:

$1000 (Payment in Full)

$500 (Half of Full Player Fee - 2nd payment due in 2 months from initial payment)

$250 (Quarter of Full Player Fee - 4 installments due monthly beginning 11/01/2016)

Off Line - Any of the above options via Check/Cash

* indicates required fields

IMPORTANT: Online Payment with credit cards is not active for this form

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Impact Baseball Player Payment Plan