TSA Foundation Clinic Registration Form
Athlete Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Sport
(Basketball, Football, etc)
Parent/Guardian Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Clinic Session Selection
Clinic Dates
*
May 30th
June 6th
Clinic Session Groups
*
Foundations Clinic-Grades 3-7 (am-11:30am)
Foundations Clinic-Grades 8-12 )12pm-2:30pm)
T-Shirt Size
T-shirt size
*
Please Select
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Enrollment Status
Is your athlete currently enrolled in a TSA program?
*
Yes-currently enrolled
No-this is our first registration
TSA Foundation Clinic-Participation Policy, Waiver & Media Form
I have read, understand, and agree to the TSA Foundation Clinic Policy, Waiver of Liability, and Media Release Authorization
*
Payment
$100 registration fee
My Products
*
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Foundations Clinic
Grades 3-7
$100.00
$
100.00
Foundations Clinic
Grades 8-12
$100.00
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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