Bill Steckis 10th Annual Free Baseball Clinic for kids

Please Print

Name____________________________________

Age_____________________________________

Address__________________________________

City/State/Zip_____________________________

Email (necessary for confirmation email)

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Home phone ______________________________

Top Position (must circle one)

Catcher Pitcher Infield Outfield

Contact person and phone number on April 26, 2009

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Bill Steckis and Creighton University cannot be responsible for injury. Bill Steckis and Creighton University is authorized to obtain any medical care or treatment deemed necessary.

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Parent/Guardian Signature (required) Date

Complete above , TEAR OFF, and mail to:

Bill Steckis Free Baseball Clinic
5457 S. 49th Ave
Omaha, NE 68117