Player's First Name*:

Player's Last Name*:

Gender*:MaleFemale

Player Birthdate*:

Player Clinic Registration 2022-23

Address:

Address2 (if any):

Your City*:

Your Province*:

Your Postal Code*:

Your Email*:

Your Phone*:

Alternate Phone*:

Adult Name on Credit Card*:

Emergency Contact Person*:

Emergency Phone*:

T-Shirt Size*:Y-MedY-LgY-XLA-SmA-MedA-LgA-XL

List Allergies - Medical Information (optional):

Sessions #1 and #2:
7:30pm - Nov 4 - Apr 7, 2023 - 20 Session - $510

Session Choice*:

SESSIONS 1 and 2

Waiver & Policy Section:

I hereby understand that the registration fee does not include medical insurance coverage. I agree to release and indemnify that Pro Player Development, its officials, head coach and instructors from any claims arising from injuries incurred by the applicant while participating in the Pro Player Development Camps.

READ PPD ASSUMPTION OF RISK WAIVER >>>
I have Read and Accept the Waiver *:I Accept the Waiver*

READ PPD MEDIA CONSENT AND RELEASE FORM >>>
I have Read and Accept the Media Consent Agreement *:I Accept the Media Consent*