“Perfect-Pitch” Home-Run Derby

 

On Line Registration form

“Take a Swing for Charity” 

Sunday, June 3, 2007

This contest is a charitable event.  It is not limited to athletes, anyone who would like to participate is welcome! 

 

Four Divisions        Major     Junior     Senior    Adults    All-Stars

                                14-16     17-18    19 - 30      31 - 44          45+

 

Prizes for 1st, 2nd, & 3rd place winners in each division, will be awarded. 

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Name________________________________ Age____________

 

 Address______________________________________________

 

 E-mail Address______________________________________  

 

Phone # (      )____________Shirt Size (Adult)    M   L   XL

 

There is a required $30.00 Donation/Registration fee per competitor.

I hereby authorize myself/my child’s photo to be used in newspapers, magazines,  television and or on the website for the “Perfect Pitch” Home Run Derby at  www.perfectpitchhrd.com in conjunction with the promotion of said derby.

 

                                                 Signature________________________________________

 Make Checks Payable To:      Perfect Pitch HRD, INC

                                                                144 North Beverwyck Road

                                                                PMB #218

         Lake Hiawatha, NJ 07034-1997 

 

****************SIGNATURE  REQUIRED FOR PARTICIPATION************************

I Hereby certify that  my child/myself has permission to participate in the “Perfect Pitch” Home-Run Derby on Sunday , June 3, 2007, at Gardner Field in Denville, NJ.  I realize that this sport involves the potential for injury, and I acknowledge that even with the use of protective equipment (cup & batting helmet)  and observance of the rules, injuries may  still occur. I hold harmless the “Perfect Pitch” Home-Run Derby including any individual, group, organization,  or corporation, all agents, officers, and employees that directly or indirectly organized, sponsored, contributed, licensed or volunteered their efforts to this event, from all causes, liabilities, damages, claims, or demands whatsoever on account of any injury or accident involving the said minor/or  self, arising out of participation in said event or in the course of additional competition and/or activities held in connection with the ’perfect Pitch” Home-Run Derby. 

Parent, Guardian, or Self (Please Print)______________________________

Signature____________________________________Date___________________