Name of player *

First Name

Last Name

Parent/Guardian name *

First Name

Last Name

Phone

(###)

###

####

Membership package *

Select one

Starter pack

Superstar pack

What night of the week would you like? *

select one or both

Wed

Thur

I hereby give my daughter/son permission to attend this Academy. The Academy will make every effort to ensure the safety of my child and I will not hold them responsible if any injury occurs. Any media taken at the Academy can be used in future promotional material. There will be no refunds given unless there is a 24hr notification. *

Tick this box to agree