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BKBA Off-Season Work Out Registration Form
PLAYER INFORMATION
*
First Name:
*
Last Name:
Street:
City:
State:
Zip Code:
Home Phone:
Birthdate:
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Email:
Grade:
K
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PARENT/GUARDIAN #1
*
Firstname:
*
Lastname:
*
EMail:
*
Cell Phone:
PARENT/GUARDIAN #2
Firstname:
Lastname:
Email:
Cell Phone:
MEDICAL/EMERGENCY CONTACT INFORMATION
*
Emergency Contact:
*
Phone:
*
Relationship to Player:
The Following needs to be brought to the players first scheduled workout: A signed Liability Waiver Form and a Check for $125 for the (5) week class. The instructor will schedule (2) sessions per week for the (5) weeks. Once the (5) weeks are complete the program is finished. If a player does not complete all (10) sessions due to absences there will be no refund.
Please download the Liability Waiver Form on the Handouts tab of this website. Have it filled out and ready to hand in before the first work out.
I/we agree with the above and will bring a Liability Waiver Form and a Check for $125 to the first workout. I also agree that the player is in good medical condition and cleared for such activity.
*
*
Age Group of Team Playing for in 2018:
* indicates required fields