Building Quality Baseball Players Since 1996

Off-Season Instruction Program

Off-Season Program - Registration

By completing this registration you are securing a spot in the selected program. You are obligated to participate for the entire time period. If you miss a class or discontinue to program you are still liable for the fee for the entire session. If you have to withdraw and your spot can be filled, appropriate arrangements will be made at that time. You may register prior to setting your weekly instruction time. It is very helpful to list your availability or your choice times in the "notes" box below. Mark Potoshnik or Stephanie Cooper will contact you to schedule that time. If your registration fee/deposit is not received within 5-7 days your spot will be forfeited.

Please provide the following registration information:

Player Name Phone Number

Parent Contact E-mail

Street Address

City League Age 2010 SEASON

State Bats/Throws Right or Left

Zip

Scheduled Time *

Instructor:
Instructors: Pitching - Mark Potoshnik

Hitting - Dan Somoza, Derek Bingham, or Mark Potoshnik

*If a time has not been scheduled. Leave this field blank and add preferred times in the notes area below.

If we can accommodate the requested time we will. If not, we will contact you to arrange a time that will work.

Winter Pitching Program (November-February)

• 16 One Hour Sessions 2 Players: 1 Coach

A payment of $230 is due on the first of each month until the end of the program session

Cost: $920.00

Deposit to hold spot: $100.00

Winter Hitting Program (November-February)

• 16 One Hour Sessions 2 Players: 1 Coach

A payment of $230 is due on the first of each month until the end of the program session

Cost: $920.00

Deposit to hold spot: $100.00

• 16 One Hour Sessions 1 Player: 1 Coach

A payment of $380 is due on the first of each month until the end of the program session

Cost: $1520.00

Deposit to hold spot: $100.00

• 16 1/2 Hour Sessions 1 Players: 1 Coach

A payment of $230 is due on the first of each month until the end of the program session

Cost: $920.00

Deposit to hold spot: $100.00

TEAM - Winter Pitching or Hitting Program (November-February)

Please specify the other players enrolling as part of your group in the 'notes' section

• 16 One Hour Sessions 4 Players: 1 Coach

A payment of $160 is due on the first of each month until the end of the program session

Cost: $640.00

Deposit to hold spot: $100.00

Please select Hitting Instruction

Or, Pitching Instruction

The $100 deposit is non-refundable and will be applied to the first months fees.

By submitting this form I, the parent/guardian of the individual named above, a minor, do hereby agree to allow the individual named herein to participate in the aforementioned activity and authorize the program directors and/or instructors as Agents for the undersigned to consent to Medical, Surgical and/or Dental Examination, in addition to any and all other Treatments that may be deemed necessary by medical personnel. It is understood that this activity involves an element of risk and a danger of accidents and knowing those risks I hereby assume those risks. In addition, I understand that by signing this agreement, I hereby release and discharge Northwest Baseball Academy and their directors from any and all liability resulting in injury associated with participant’s participation in this activity. I agree that pictures taken during program hours may be used for future promotional purposes. In the absence of a parent/guardian signature below, payment of fees and participation in the program shall constitute acceptance of the conditions set forth in this release. Northwest Baseball Academy will not provide health and/or accident insurance for program participants.

Additional Information: