Summer OGP Application
$130/week. Discounts available for Multiple Children or Monthly Rate
Child’s Name
*
First Name
Last Name
Will additional sibling(s) be participating?
*
Yes
No
If yes, enter their names below.
First Name
Last Name
First Name
Last Name
Will your child be participating for the full summer at a discounted rate?
*
Please Select
Yes, full summer
No, only weekly
What sports is your child interested in?
*
How old is your child/children?
Are there any behavioral or special issues we need to be aware of for your child in order to meet their individual needs?
*
Please list any of the following: Current medications, medication allergies, food allergies, or chronic health concerns.
*
Photo/Video Release: I grant permission for Iuka Sports Academy to use photographs or video recordings of my child for promotional purposes:
*
Yes
No
Parents Name
*
First Name
Last Name
Parents Email
*
example@example.com
Parents Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signature
*
Submit
Should be Empty: