Positional Play & Gameplay

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Athlete's First & Last Name *

Check session(s) registering *

Positional Play: Tues, Sept 16 @ 7:30 - 9:00pm ($255)

Gameplay : Thurs, Sept 18 @ 7:30 - 9:00pm ($255)

Single Session Drop-in ($35)

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Select date of drop-in (leave blank if not applicable)

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Athlete's Birthday *

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Allergies & Heath Concerns (if any)

Mailing Address (Please include City & Postal Code) *

Parent Name(s) *

Parent Email(s) *

Parent Contact Number(s) *

Emergency Contact Name *

Emergency Contact Number *

Relationship to athlete (emergency contact) *

Media Release Consent *

I have read the Media Release Consent and fully understand the contents and meaning of the release. I understand that I am free to contact Rampage, with any concerns regarding the release.

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Waiver & Release of Liability *

I confirm that I have read and fully understand the Waiver and Release of Liability.

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