Sports Clinic - Registrations 2024-2025

REGISTRATION FORM

2024-2025 - SPORTS CLINIC Club (This registration is valid for the whole school year)

Monthly price:

Once a week (1) $70.00

Twice a week (2) $115.00

Three times a week (3) $155.00

Four times a week (4) $195.00

Note: There is a one time registration fee of $25 (Cash/Venmo/Checks)

Checks: made to DSA

Venmo: @dsaSports

NO ZELLE!!!

Write YES or NO in the box with the days your choice:

MONDAY

K-2 Soccer / 3rd-5th Multisport

TUESDAY

K-2 Multisport / 3rd-5th Soccer

WEDNESDAY

K-2 Soccer / 3rd-5th Multisport

THURSDAY

K-2 Multisport / 3rd-5th Soccer

Participant's name

Grade

Mom's name

Cell

Email

example@example.com

Dad's name

Cell

Email

example@example.com

Emergency contact's name

Cell

Medical Needs (Allergies) / Other Special Needs

Additional Persons Authorized to Pick Up:

1

2

I have read, agreed, printed, and made a copy of this Registration Form as well as the Sports Clinic Program Parent and Student Handbook, including the Parent Contract and Student Code of Excellence; and agree to cooperate with all of the policies contained therein. (All these documents can be found in the DSA Clubs website: www.DSAisFun.com)

Parent/Guardian (Print name)

ParentGuardian Signature

Date

* Parents/guardians must understand that this type of program may incur injury. Any and all expenses and medical care will be the responsibility of the parents/guardians. Neither the school nor DSA Sports & Recreation, Inc. will be held liable.