Positional & Gameplay Program

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please provide an email address to receive a copy of the registration.

Email *

Athlete's First & Last Name *

Check session(s) registering *

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

Single Session Drop-in ($35)

Required

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

YYYY

Athlete's Birthday *

YYYY

Current school attending:

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.

Required

Waiver & Release of Liability *

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

Required

Almost Done!
Please don’t forget to click the "submit" button below to complete your registration.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

Forms

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google.