2024 CCHS Field Hockey August Clinic Registration Form

2024 CCHS Field Hockey August Clinic

REGISTRATION FORM

Join the 2024 CCHS Field Hockey Captains, assisted by the CCHS Field Hockey coaches, for a 3-day clinic focused on skill development, small group play, and fun! No field hockey experience is required, all players - from brand new to experienced - are welcome and encouraged to participate. Players will be grouped by age and ability.

WHO: Student-athletes entering grades 6-9
WHEN: 8:30 AM - 12:30 PM on August 14-16, 2024
WHERE: Concord-Carlisle High School, Upper Turf

COST: $200 - Proceeds support the CCHS Field Hockey program

Space is limited so register today by completing the form below.

Questions? Please contact cchsgfh@gmail.com

Student-Athlete Information

Player Name*

First NameLast Name

Grade player will enter in the Fall of 2024*

Grade 6Grade 7Grade 8Grade 9

School attending in the Fall of 2024*

Player's experience playing field hockey*

Never played field hockey beforePlayed for school teamPlayed for league / club team

Size for clinic t-shirt (fit tends to run large)*

Parent / Guardian Information

Parent / Guardian Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Emergency Contact / Medical Information

Emergency Contact Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Relationship to player*

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe. *

Is the athlete prescribed an inhaler or an EpiPen? If yes, please provide any instructions.*

Medical Release & Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is also granted to Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature

Payment

If you prefer PayPal/Venmo, please consider covering the transaction fee by selecting both products before you proceed to checkout. If you prefer to pay by check, please select the Purchase Order option and follow the instructions to finalize payment. How would you like to pay for the clinic fee?

PayPal/VenmoPurchase Order (please click TWO Submit buttons to complete the registration)

2024 CCHS Field Hockey August Clinic FeePlease complete a registration form for each player if you are registering multiple student-athletes.

$200.00 Quantity

Donation to Cover Transaction FeeSelect this product in addition to the clinic fee if you would like to cover the transaction fee.

$7.50 Quantity
Item subtotal:$0.00

Total

$0.00

Payment Methods

Please click one of the PayPal options to complete payment and submit the form.