Player Information:
Your Name
Address
City/State/Zip
Birthdate
Sex
Home Phone
School Attending
Parent/Guardian Information:
Alt. Phone
Parent/Guardian
Alt. Phone
Parent/Guardian
Preferred Email(s)
Emergency Contact Information:
Alternate Contact
Phone
Phone
Preferred Doctor
Phone
Preferred Dentist
I.D. #
Insurance Carrier
Winter Training
Session
1
I
magine Schools
Gold Package
(1 Day per Week)
Winter Training
Session 1
Imagine Schools
Platinum Package
(2 Days per Week)
