2026 ACADEMY REGISTRATION FORM
PLAYER INFORMATION
All fields are required
First Name
*
Last Name
*
Player date of birth
*
Gender
*
Enter Player's Gender
Male
Female
Street Address
*
City
*
State/Province
*
ZIP / Postal Code
*
PARENTS INFORMATION
PARENT 1 Select Relationship
Mother
Father
Parent 1 First Name
*
Parent 1 Last Name
*
Parent 1 Phone
*
Parent 1 Email Address
*
PARENT 2 Select Relationship
Father
Mother
Parent 2 Name
Parent 2 Phone
Parent 2 Email Address
HEALTH INFORMATION
Please upload in pdf of jpeg format these two documents
Insurance Card
*
Choose File
No file chosen
Delete uploaded file
Immunizations Record
*
Choose File
No file chosen
Delete uploaded file
PAYMENT INFORMATION
Credit Card Number
*
Expiration Month
*
Expiration Year
*
CVV
*
Charges
I authorize charges for 10-credit packs (members & non-members), single group sessions (non-members) and private lessons in the above credit card
DISCLAIMER OF LIABILITY
Agreement
I Agree with the disclaimer of liability
Submit