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July 17 Kids Clinic Registration Form

Thank you for your interest in the 2007 SPL Kids Clinic. Please fill out the form below and click submit. THE FORM MUST BE COMPLETED BY A LEGAL GUARDIAN 18 YEARS OR OLDER. A release and waiver will be required from all legal guardians before any child is allowed to participate. The waiver will be sent to you along with a confirmation email with more information. This waiver may be faxed back to our league office at (310) 693-6186, mailed to us, or brought with you to the Clinic.

Location: Nike's "The Point" in Hollywood

Date: Tuesday, July 17, 2007

Time: 10-14 age group will begin at 11:00 am. 15-18 age group will start at 2:00 pm. Please arrive 30 minutes early.

 

Name of Legal Guardian: Relationship:
Kids Attending (Full Names):
1.
2.
3. 		Age of Kids:
Parents' Information:  
Address:
City:
State:
Zip: 		Telephone 1:
Telephone 2:
Email:
Emergency Contact Person:  
Name:
Relationship: 		Telephone 1:
Telephone 2: