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REGISTRATION FORM
Program Training
GUARDIAN INFORMATION
Father's name
Your answer
Mother's name
Your answer
Mailing address
Your answer
Home phone
Your answer
Father's Cell phone
Your answer
Mother's Cell phone
Your answer
Father's email
Your answer
Mother's email
Your answer
PLAYER INFORMATION
Player's name
Your answer
Gender
Player's birthdate
MM
/
DD
/
YYYY
School name
Your answer
Current level of play (e.g.. U-14 Metro)
Your answer
Emergency contact #1 (name and number)
Your answer
Emergency contact #2 (name and number)
Your answer
MEDICAL AND INJURY HISTORY
Medical
Your answer
Injuries
Your answer
TYPE OF COACHING REQUIRED
Group or team roster (first and last names)
Your answer
What are your goals for the training sessions?
Your answer
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