Pinnacle Academy Registration
Player Registration
Student Athlete Name
*
First Name
Last Name
Gender
*
Please Select
MALE
FEMALE
Parent/Guardian's Name
*
First Name
Last Name
Parent/Guardian's Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Student Athlete Birth Date
*
-
Month
-
Day
Year
Date
Student Athlete Current School
*
Student Athlete Current Grade
*
Pinnacle Coach Name
*
Describe Athlete Level of Play
Registration Fee
*
prev
next
( X )
USD
Non Refundable Fee**
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
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