CBM Athletics-Fall Registration Form
Please answer the questions below so we have updated contact information and general information about your child as we begin our work together. You will receive a confirmation email within 24-48 hours of registration.
Child's Last Name *
Child's First Name *
Child's Grade Level *
Child's Age as of 9/1/21 *
My child needs to focus on (select all that apply). *
Required
My child plays the following sports (select all that apply). *
Required
I would like to sign my child up for the following session(s), beginning the week of September 6. *
Required
Please list any allergies that your child may have and the reaction that occurs. *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Second Parent/Guardian Last Name
Second Parent/Guardian First Name
Second Parent/Guardian Email Address
Second Parent/Guardian Phone Number
Emergency Contact Information (please include the first name, last name and phone number of two adults that can be contacted in case of emergency) *
If there is anyone that is not allowed to pick up your child from our session, please indicate their name here.
I agree to print out the liability waiver that will be emailed to me after registration, sign it and bring it to the first training session. *
I am aware that I will be responsible for paying $25 for my child to attend each session. The fee is due on the day of the session and can be paid in cash or Venmo to @Beth-McCoy-26. *
My child's photo/video may be included on the CBM Athletics website or Facebook page. *
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