Year in School Pitching Session (Circle One) Hitting Session (Circle One)
Birth Date 4:00
5:00
6: 00
4:00
5:00
6:00
I give permission for my son to participate in the South Dakota State University Jacks Baseball School knowing that the sessions will involve rigorous physical activity and could lead to injury. I authorize the directors of the Jacks Baseball School to act for me using their best judgment on any emergency requiring medical attention. I know of no mental or physical problems that will affect my son’s ability to participate in the Jacks Baseball School. I hereby waive and release South Dakota State University form any liability involving injury or illness. Parent/ Guardian Signature:
Date
RETURN FORM TO: Brian Grunzke South Dakota State University Baseball 2820 HPER Center Brookings, SD 57007