CYC Registration Form

Fill out the form carefully for registration!
Parent/Guardian's Name
Parent/Guardian's Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Player Name

First NameLast Name
Date Of Birth

DayMonthYear
Playing Position
Please Add Any Details Regarding Objective For 1 To 1 Sessions.
Do You Have Any Medical Conditions?
If 'Yes' please explain briefly?
Activity
Activity - Week 1
Activity - Week 2
Activity - Week 3
If your looking for 1-2-1 session Please tell me you preference time?
Would You Like To Be Add To CYC WhatsApp Group?
Please confirm that you give consent for any photos / video taken in the sessions can be uploaded on to the social media and website of Can You Challenge!
Additional Information:
Should be Empty: