Online Player Registration Form

   Player's Name:  

   Activity Participating In:  

   Age:          Birth date:  // ex. (05/10/91)       Gender:          Select Boy Girl

   Parent or Guardian  Name:  

   Address:  

   City:      State:         Zip:    

   Home Phone: ()                            Cell Phone: ()

   Emergency Phone: ()       Who are we calling?:  

   E-Mail Address:  

  How did you hear about The Sports Academy?          Select Building Sign Friend Returning Player Summer Camp Flyer Travel League Web Yellow Pages Other:

     If you selected Friend, Travel League or Other, please list specific name here:
                              

   Method of Payment?          Select Mail Check Online Pay via PayPal

   I hereby give permission and certify that I (or my child is) am in good health and able to
  participate in all The Sports Academy activities.  By selecting the SUBMIT button, I release
  coaches, staff, and all others associated with The Sports Academy activities of all Liability
  for any injury or illness incurred by me (or my child) at The Sports Academy activities.

    Date:          Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec          1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31          2008