Registration Form

JAX COMPETITIVE INDIVIDUAL DEVELOPMENT TRAINING

Registration Form
Please fill out one registration per participant. An email will be sent upon acceptance to the program. A payment link will be emailed to you along with required waivers.
PARTICIPANT INFORMATION:
Participant Name*

First NameLast Name
Birth Date*

MonthDayYear
Participant Experience Level*

MLS IIECNL-RNPLOther
Program Option (Note that the Partial Program only includes field training not strength training):
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Shirt Size

NOTE: Shirts are not included at this time, however, if shirts become available, the shirt size is needed.
Adult Shirt*
Youth Shirt (if applicable)

JAX COMPETITIVE INDIVIDUAL DEVELOPMENT TRAINING