KID Baseball Breeze 2017 SPEND A DAY AS A The Hubert V. Simmons Museum of Negro Leagues Baseball, Inc. SPEND A DAY AS A KID Baseball Breeze 2017 LOCATION - Owings Mills, Baltimore County Public Library County Campus Metro Centre at Owings Mills 10302 Grand Central Ave, Owings Mills, MD 21117 WHEN July 17th- 21st 2017: TIME: 9:30AM – 3:00 PM All Youth Invited Between the Ages of 8 and 14 COST - $10.00 PER CAMPER Camp Activities Include: Tour of the Baseball Museum, Baseball Youth Activities, Reaper’s Den-Columbia, MD, and more! To Register Contact: Deirdre Harris, Director at 443-517-8719 Desney Green, Assistant Director at  410-951-6409 Parent or Guardian Permission Forms and Medical Information Required - No Exceptions! REGISTRATION FORM DEADLINE: JULY 13, 2017

The Hubert V. Simmons Museum of Negro Leagues Baseball Inc. KID – BASEBALL BREEZE 2017 July 17th- 21st 2017: TIME: 9:30AM – 3:00 PM All Youth Invited Between the Ages of 8 and 14 COST - $10.00 PER CAMPER-PAYMENT DUED WITH REGISTRATION FORM Camper’s Name _______________________________________ Birth date ________________ Home Phone ____________________________ Gender__________ City __________________ State _________ Zip _____________ Mother’s Name _________________________________Cell/Home Phone___________________ E-mail __________________________________ Father’s Name ____________________________Cell/Home Phone_________________________ E-mail ________________________________ I/We the parent(s) of the above named child hereby give my/our approval to his participation in any and all of the activities of the Hubert V. Simmons Museum of Negro Leagues Baseball, Inc. Baseball Summer Camp. I/We also agree to a photo release so that Hubert V. Simmons Museum of Negro Leagues Baseball, Inc. may use my/our child’s photo for promotional use of the museum.   I/We assume all risks incidental to the conduct of the activities and transportation to and from the activities. I/We do further hereby release, absolve, from indemnity and hold blameless the Hubert V. Simmons Museum of Negro Leagues Baseball, Inc. Baseball Summer Camp, the organizers, the sponsors, and the supervisors, any or all of them, in case of injury to my/our child. I/We likewise release from responsibility any person transporting my/our child to or from activities. I/We the parents of the above named child, in case of emergency and/or injury in my/our absence, hereby authorize any hospital and/or attending physician to give emergency medical attention or treatment deemed necessary. Parent(s) Signature: __________________________________________________   Family Physician’s Name: _____________________________________________ Phone Number: _______________________________Date:__________________ Contact Deirdre Harris, Director at 443-517-8719 Desney Green, Assistant Director, at  410-951-6409 Parent or Guardian Permission Forms and Medical Information Required –No Exceptions!