2023 Nipmuc Youth Baseball Clinic
Thank you for your interest in the baseball clinic. Please have your athlete bring a glove and a water bottle. Bats are encouraged but not required, cleats are not necessary. The clinic will run from 9-12pm at the Nipmuc HS baseball field. 
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Email *
Student Name *
Student Grade *
Describe your student's level of experience *
Parent Name *
Parent Cell Phone *
Emergency Contact  *
Relationship to Student *
Emergency Contact Cell Phone *
Does your student have any allergies? *
If yes, do they carry an epi-pen? *
Nipmuc Athletics Medical Liability Release Form

In consideration of being allowed to participate in any way in any Nipmuc Athletic team, participants acknowledge, appreciate, and agree that:

1. The risk of injury/illness from the activities involved in these sport events is significant, including the potential for exposure to COVID-19, permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.

2. Participants knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for their participation.

3. Participants willingly agree to comply with the stated instructions and policies and customary terms and conditions for participation. If, however, a participant observes any unusual significant hazard during their presence or participation, they will remove themselves from participation and bring such to the attention of the nearest Mendon-Upton School district employee immediately.

4. Participants, for themselves and on behalf of their heirs, assigns, personal representatives and next of kin, hereby release, indemnify  and hold the town of Mendon, the town of Upton, and the Mendon-Upton Regional School District, and their officers, officials, agents and/or employees, other sport participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event or activity (“Releases”) harmless with respect to any and all injury, disability, death, or loss or damage to person or property, to the fullest extent permitted by law.

I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN ME AND MENDON UPTON REGIONAL SCHOOL DISTRICT AND SIGN IT OF MY OWN FREE WILL.

(Parent Electronic Signature Below) 
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