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Plyometric/Shooting Program
Registration Form
Players Name: ___________________________________ ( ) Male ( ) Female
Address: __________________________ City/State/Zip:______________________
DOB: ________ School: __________ Email: _________________________________
Shirt Size: YS YM YL -OR- AS AM AL AXL AXXL (circle one if applicable)
Guardian 1 Name: __________________________ Phone: (h) ___________________
(c) _________________ (w) ________________ Email: _______________________
Guardian 2 Name: __________________________ Phone: (h)___________________
(c) _________________ (w) _________________ Email: ________________________
Receive notifiation via text Messaging ____YES____NO Cell Provider:______________
SESSION I
July 30 - August 31, 2012
Two Days.........$175.00 Three Days......$250.00
(Mark the days you would like to attend)
Monday Wednesday Friday
SESSION II
September 10 - October 12, 2012
Two Days.......$175.00 Three Days......$250.00
(Mark the days you would like to attend)
Monday Wednesday Friday
ALL CONFIRMATIONS WILL BE MADE VIA EMAIL
Please complete and return this registration form with your non-refundable
registration fee for the approprate session to The Gym of Springfield,
1823 Camp Lincoln Road,Springfield, IL, 62707 before the beginning of the session. |