Instructor Application

Full Name*

Mailing Address*

Phone*

Email*

Do you operate as a sole proprietor?

Yes

No

Number of athletes (approx.)*

Type of lessons*

Hitting

Defense

Pitching

Catching

Other

School districts athletes represent*

Any additional goals for requesting membership at The Clubhouse?

Any additional offerings you would like to see at The Clubhouse?

I have read and agree to the Release of Liability

By signing below, I confirm that all information provided is true and complete.*

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5:00AM - 10:00PM

7 Days a Week

105 Green Valley Drive, Mt. Zion, IL 62549

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