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BASES LOADED BASEBALL & SOFTBALL ACADEMY

Baseball & Softball Registration

RELEASE OF LIABILITY

In consideration of being allowed to participate in any way in programs offered by Bases Loaded, LLC and related events and activities, the undersigned acknowledges, appreciates and agrees that:

1. The risk of injury/illness, including Covid-19, from the activities involved in this program and related activities is significant, including the potential for permanent injury and death, and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury/illness, including Covid-19, does exist; and

2. I knowingly and freely assume all such risks, known and unknown, even if arising from the negligence of Bases Loaded, LLC, its employees or agents, or others and assume full responsibility for my (or my child’s) participation; and

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual and significant hazard during my presence or participation, I will remove myself (or my child) from participation and bring such to the attention of the nearest instructor or volunteer immediately; and

4. I, for myself and on behalf of my heirs, assigns, and personal representatives, release Bases Loaded, LLC, its employees, members and agents as well as other participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the programs (“Releasees”), with respect to all and any illness, including Covid-19, injury, disability, death, or loss or damage to person or property whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND THE TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. PARENT'S SIGNATURE IS REQUIRED IF PARTICIPANT IS UNDER 18 AT TIME OF REGISTRATION.

Today's Date: October 30, 2025

First Participant's Name
First Name*
Last Name*
Phone*
Select Gender
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Second Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Third Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Third Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Fourth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Fifth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Sixth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Seventh Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Eighth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Ninth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Tenth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree that my child may participate in all programs offered by Bases Loaded, LLC and consent and agree to his/her release, as provided above, of all Releases, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liabilities to my minor child's involvement or participation in these programs and related activities as provided above, even if arising from their negligence, to the fullest extent permitted by law. I also understand that no refund of any fees paid will be given in the case of dismissal for disciplinary reasons; that no drugs or alcohol may be brought into or consumed on the premises at which the programs take place and any entity/persons associated with the programs reserve the right to suspend or expel any participant who violates any rules or whose behavior or style of play is considered unsportsmanlike, uncontrollable or a risk to other players. I permit and authorize Bases Loaded, LLC to use, display, modify, adapt, reproduce, publish, or distribute my photograph or other likeness for publicity, marketing, promotion and other commercial purposes.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Select Gender
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information

Clinics


Clinics are limited to 4 players per clinic and cost is $175 per player, per 4 week clinic. In-Season/Pre-Season is $325 per player, 6 week clinics are $260, 8 week clinics $325.

Baseball/Softball Hitting Clinics - age 7-8,9-12/13+
Baseball/Softball Pitching Clinics - age 7-8,9-11/12+
In-Season/Pre-Season Clinics - age 9-12/13+
Mechanics, Strength & Velocity Clinic
Hitter's Edge
Other (includes Holiday Clinic)

Private Lessons & Semi-Private Lessons

Private Lessons Jim Neidlinger - $65/hr. Block of 4 - $260 (ages 9+) Other Instructors - $60/hr. Block of 4 - $240
Semi-Private Lessons $43.75/hr per participant - max of 2 participants Block of 4 - $175 per participant - max of 2 participants
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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