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JUST KEEPERS ACADEMY REGISTRATION FORM
Goalkeeper’s Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Please Select
Male
Female
N/A
Playing Level
*
Please Select
Recreational
Juniors Academy
Select
Pre-ECNL
ECNL
Other
Current Team/Club
*
Years of Experience as a Goalkeeper
*
T-Shirt Size
*
Please Select
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Emergency Contact Information
Parent/Guardian Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
How did you hear about us?
*
Please Select
Social Media (Facebook, Instagram, TikTok, YouTube)
Sponsored Ads
Word of Mouth
Team/Club
Existing Goalkeeper
Other
Photo/Video Release
*
I grant permission for photos and videos to be taken during sessions to be used for training purposes and program promotion
I DO NOT grant permission for photos and videos to be taken during sessions to be used for training purposes and program promotion
IMPORTANT: NEXT STEP REQUIRED
After submitting this registration form, you will be redirected to purchase the New Keeper Evaluation and schedule your training session. You must complete both steps to finalize your registration. Please do not close the page before completing this process.
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