Participation / Waiver Form

Player's Name

First NameLast Name
Which Area?
Grad Year
Grade Level
in the Fall of...
Birth Date

MonthDayYear
Jersey/Shirt Size
6 months from now
Shorts Size
6 months from now

Preferred Jersey Number (Between 0-99)

Rows	1	2	3
Top 3 Choices

You must choose 3 different numbers.
LET US KNOW WHICH YOU CARE MORE ABOUT SO WE CAN BEST SERVE YOU. We see all options as positive.

Which BEST describes your player, their parent/guardian, and the other parent/guardian (if applicable)

Rows	Full Name	From where do you draw your energy?	How do you take in information?	How do you make decisions?	How do you organize your world?
PLAYER
GUARDIAN 1
GUARDIAN 2 (or N/A)

{parent1name}'s Email
Best email for future contact
{parent1name}'s Phone

Area CodePhone Number
{parent2name}'s Email
or alternative email, if no second guardian
{parent2name}'s Phone

Area CodePhone Number
{playername}'s Email
or alternative email, if player has no email
{playername}'s Phone

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternate Address (if applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Waiver Acknowledgement
prevnext( X )
Include a free copy of the $50 monthly homework bookFree

I'd like to purchase the $150 curriculum now at a discounted price$100.00
This includes our daily itinerary of drills, monthly homework, daily challenges, motivational stories, and much more. Alternatively, each player may take months to earn this on their own. This discount is a one-time offer upon completion of this form.

Total $0.00
Calculation 1
Grad Calc
PLAYER
PLAYERNAME
PARENT1NAME
PARENT2NAME
PARENT1
PARENT2
PLAYER RESULTS
PARENT1 RESULTS
PARENT2 RESULTS
PLAYER OPTIONS
PARENTONE OPTIONS
PARENTTWO OPTIONS
Should be Empty: