This web site is the property of Dave Henderson Baseball Adventures.
All inquiries should be addressed to dhbaweb@hendersonbaseball.com
© DHBA 1999-2012
Everett Aqua Sox Adult Weekend Camp
August 11-13, 2012
Make checks payable to or, FAX your completed registration form with credit card information to (509) 277-0327
Dave Henderson Baseball Adventures and mail to:
Dave Henderson Baseball Adventures, LLC
W 2003 Broadway
Spokane, WA 99201
Instructions: please fill out this form and then you may print out the form and fax or mail to the above address or fax number. If
you fax or mail your form please use a live signature at the bottom, you accept this as your live signature for the purpose of the
camp charging your card.
Weekend Camp Price: $950
Name: _____________________________________Email:____________________________________________
Address: ___________________________________________________City: _____________________________
State: _______Zip: ____________ Day Phone: __________________ Evening Phone: _____________________
Occupation: _________________________________ Age: _______
Height: ______ Weight: ______ Waist/Inseam: ________ Jersey size: S M L XL XXL XXXL Desired Number: _____
Please list any medical conditions that may effect your participation in camp:
_______________________________________________________________________
_______________________________________________________________________
Payment Information:
Charge my credit card in the amount of $_________($250 deposit required)
Visa___ MasterCard ___
Card#: ____________________________________________
Expiration Date: ____________ Card Holder Name: _____________________________
Signature: _____________________________________________________________