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© DHBA 1999-2012
Mariners Fantasy Camp 2013

January TBD Dates
Anyone 30 years of age or older is eligible to participate in the Mariners Fantasy Camp 2012. Space is limited and priority will be given based upon postmark on registration form. Payment of $3,900 (Standard Package) or $4,975 (VIP package) can be made in full or send a deposit of $800 (for either package) to reserve your spot, balance must be received by October 15, 2012 Visa and MasterCard accepted. Some additional fees may be imposed on signups after November 1. Both packages include airfare from Seattle, Spokane or Portland.

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.

Please check Fantasy Camp Package choice
___ Standard ($3,900) ___ VIP ($4,975)

Name: _____________________________________Email:____________________________________________

Address: ___________________________________________________City: _____________________________

State: _______Zip: ____________ Day Phone: __________________ Evening Phone: _____________________

Occupation: _________________________________ Age: _______

Height: ______ Weight: ______ Waist/Inseam: ________ Jersey size: 40 42 44 46 48 50 52 Desired Number: _____

Please list any medical conditions that may effect your participation in camp:

_______________________________________________________________________

_______________________________________________________________________

Payment Information:

Charge my credit card in the amount of $_________($800 deposit required)

Visa___ MasterCard ___

Card#: ____________________________________________

Expiration Date: ____________ Card Holder Name: _____________________________

Signature: _____________________________________________________________