Elite Athletes Academy
Enrollment Form
Student's Name
First Name
Last Name
Student's Date of Birth
-
Month
-
Day
Year
Date
Place of Birth
Gender
Please Select
Male
Female
Sport/Recreational Activities
Please Select
Softball
Field Hockey
Cross Country
Cricket
Rugby
Dance
Rodeo
Baseball
Football
Soccer
Gymnastics
Surfing
Basketball
Volleyball
Cheerleading
Self Defense
Golf
Tennis
Horseback Riding
Lacrosse
Track & Field
Other
Residential Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of last school attended
Grade Year for 2023-2024
Please Select
Grade 5
Grade 6
Grade 7
Grade 8
Legal Guardian Name #1
First Name
Last Name
Legal Guardian Occupation #1
Mobile Phone Number
Please enter a valid phone number.
Email
example@example.com
Legal Guardian Name #2
First Name
Last Name
Legal Guardian #2 Occupation
Mobile Phone Number
Please enter a valid phone number.
Attach Scan copy of Student Behavior Records/Student Academic Notes & Records
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of
Attach Scan copy of Report Card from 2023-2024
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Attach Scan copy of Physical & Medical Certificate of Insurance
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Signature
My Products
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Enrollment Application
1 Family Enrollment to Elite Athletes Academy
$
299.00
Quantity
1
2
3
4
5
6
7
8
9
10
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.
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