Sports Club REGISTRATION FORM 2025-2026

REGISTRATION FORM

2025 - 2026 SPORTS CLINIC Club (Valid for the whole school year)
Information:

(There's a one time Registration Fee of $30.00)

Once a week (1) = $80.00

Twice a week (2) = $125.00

Three times a week (3) = $165.00

Four times a week (4) = $205.00
MONDAY: K - 2nd (Soccer) / 3rd - 5th (Multi-sport)

TUESDAY: 3rd - 5th (Soccer) / K - 2nd (Multi-sport)

WEDSNESDAY: K - 2nd (Soccer) / 3rd - 5th (Multi-sport)

THURSDAY: 3rd - 5th (Soccer) / K - 2nd - (Multi-sport)
Choose the days
MONDAY

YESNO
TUESDAY

YESNO
WEDNESDAY

YESNO
THURSDAY

YESNO
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 AllergiesOther Special Needs
Additional Persons Authorized to Pick Up:
1
Additional pick-up name # 1
2
Additional pick-up name # 2
I,
Your full name
, 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)
* 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.
Parent/Guardian Print name
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
Should be Empty: