Clinic Registration Form

Clinic Registration Form
Player Name

First NameLast Name
Player Birth Date*

MonthDayYear
Clinic Date Attending
Note : Enrollment maximum of 12 participants per clinic: Age between 7-12.
Parent Contact Name

First NameLast Name
Parent Contact E-mail*
example@example.com
Waiver - Please sign below to acknowledge that a waiver by a parent or a legal guardian is required in order to participate in the clinics- A waiver will be sent to your email after registration*
Parent Contact Phone*
Should be Empty: