Madison Country GK & Attacking Clinic
Thank you for your interest in our Goal Keeping and Attacking program in Madison County. Please complete the following registration information. Payment will need to be in cash or check and is due at the first session.
Contact Details
Name *
Name of participant
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Street Address *
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City, State Zip *
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Primary Telephone Number *
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Secondary Phone Number
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Email *
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Emergency Contact Name *
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Emergency Contact Phone Number *
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Allergies *
If Yes, list Allergies or Medication
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Session *
All sessions are at the Waverly Yowell Gym
I agree to the terms and conditions of participating in a WCS Program *
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