JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
[Sunday] Spring Classes
Thank you for joining Jp Sports Clinic!!
Time : 10:30~12:00
Place : Hampton park - Cage (225 Hampton Rd, Victoria, BC V8Z 1H2)
Contact: 778 533 2848 or
jpsportsclinic@gmail.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Player Information
Family Name
*
Your answer
First Name
*
Your answer
Age
*
Your answer
Gender
*
Your answer
Birthday
*
Your answer
School Name
*
Your answer
Grade
*
Your answer
Dominant foot
*
Choose
Right
Left
Ambidextrous
Special Notes & Requests (Allergies, medication, or special needs etc. if any)
Your answer
Applicant Information
Family Name
*
Your answer
First Name
*
Your answer
Relationship to Student
*
Your answer
Address
*
Your answer
Postal
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Emergency Contacts
*
Your answer
#1 Name / Relationship / Phone
*
Your answer
#2 Name / Relationship / Phone
Your answer
#3 Name / Relationship / Phone
Your answer
Please check a box if you agree
*
The lesson fee is $20 each lesson per parson. You will make a fee payment once a month with e-transfer
Cancel fee: When players need to absent a lesson via self-convenience such as sickness, family matter, and so on, we receive a half lesson fee, $10 each. (When you notice before 1 month, there will be no cancellation fee)
Sibling discount: When a player has siblings and they participate together, we discount $5 per sibling in each session.
Introduction discount: When you introduce a new player for us, we deduct $20 per new player from a monthly lesson fee.
Required
Photo use approval
By checking a box, I give consent for interviews, photographs or videos of my child to be used on websites or publications by JP Sports Clinic.
Insurance policy
When you send this registration form to us, a player will join automatically our insurance up to $2M coverage
Please Download our communication tool !! We prefer you to download communicate application called "BAND". It will make you can see the contents of practice and practice picture or movie. Please download from this URL or QR code, Thanks
https://band.us/n/acaa69Qdq0u46
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
