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2021 St. Cloud AC Baseball Signup

Questions marked with a * are required

First and Last Name:

Employer:

Address/City:

Phone Number:

Email Address:

Medical / Emergency Contact Information

Physician:

Physician Location:

Physician Phone:

Any special medical conditions/restrictions:

Emergency Contact Name / Phone Number

Membership Dues:

$10 - Single

$20 - Family

$200 - Lifetime Family

$0 - Current Lifetime

Player's Fee

$30 per player

Worker’s Fee
*Will be returned upon fulfilling the required working hours. Number of hours will be determined after schedules are released.

$100

$0 - Current Summer St. Cloud Athletic Club Director

Please mail the fees above to the below address. Please submit any questions to stcloudbaseballcalendar@gmail.com.
St. Cloud Athletic Club
911 Main Street
St. Cloud WI, 53079

PERMISSION STATEMENT

I hereby give permission for the above named player to practice & compete in all activities of the St. Cloud Athletic Club. I agree to be financially responsible for any and all injuries that may occur during practice or play. I will not hold the St Cloud Athletic Club or volunteers responsible in the event of accident/injury as a result of my participation. I also give permission that in case of an injury I may be treated or given immediate care by any authorized physician available.

I Agree