Last Name (athlete) *:

First Name (athlete) *:

Street Address *:

City *:

State *:

Zip Code *:

Phone Number *:

Email (for confirmation):

Parent/Guardian *:

Parent/Guardian Phone *:

School Athlete Attends:

Grade (in or coming out of) *:

Private/Semi-Private Select *: - Select - Private Semi-Private

Gender *: - Select - Male Female

If registering in a Semi-Private group of 2 - 3 people you must list the other people below.
Each person must register themselves in the Semi-Private group.

Also note in box below if you have specific skills you want worked on or general.

Other names and/or skills to work on:

How Did You Hear Of Us: - Select - Friend Flyer Newspaper Email Other

Fee *: - Select - $25.00 (1 Sesson, 1 player) $130.00 (6 Sesson Package, 1 player) $20.00 per player(1 Sesson, 2-3 players) $95.00 per player (6 Sesson Package, 2-3 players) x
Best price is with 6 Sesson Package!

You may want to print this form for your records before hitting the Buy button below which will take you to the shopping cart for checking out.

If adding more than one athlete to your shopping cart you can hit the back arrow on your browser bar in the cart to come back here and modify this form to submit a second and third athlete.
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(Payment options at checkout)