Parent or guardian must provide First & Last Name
Injury Waiver Signature
*
Today's Date
*
Commitments & Acknowledgments Signatures
I certify that I have read all terms and conditions as described in the above document, and that I have discussed them with the Club North representative named within, and that I fully understand, accept and agree to be bound by the terms.
Providing names, and dates in the following spaces, act as legal signatures pertaining to joining Club North.
Player First Name
*
Player Last Name
*
Player's Birthdate
*
Ex: 07-11-20
Grade during fall of 2024
*
Provide Team Age Group
*
Example: Boys 14's
Club Reps Name / Signature:
Patty Reynolds
Today's Date
*
Provide parent / guardian contact info:
Parent First Name
*
Parent Last Name
*
Parent Cell #:
*
Ex: 816-456-4567 (include area code)
Parent E-mail:
*
Parent #2, Cell
Parent #2, E-mail
Once you have filled out the form to your satisfaction, provide the security code, then click SUBMIT. Your info will be sent to us and you will be taken to our online payment system provided by Snap! Spend. Select your the Boy's Team with the Age Group you are offered.
Security Code
*
Click the Submit Button only once; do not double click.
If, on clicking Submit, you get a RED screen - scroll back up to review; you have inadvertently failed to provide information in a "required" field(s).