Child Information
Player First Name:
Player Last Name
Player DOB:
Grade:
School Attending:
Parent Name:
Parent Email(s):
Parent(s) Cell:
Are you interested in Clinic Trainings only and NOT teams?	- Choose an Option - Yes No

Requested Information
Player Gender	- Choose an Option - M F

Waiver Agreement:
I agree to the waiver seen below.	I AGREE

Additional Info
Comments: