Parent or guardian must provide First & Last Name
Injury Waiver Signature
*
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
*
Example: 07-11-20
Today's Date
*
Provide parent / guardian info:
Parent First Name
*
Parent Last Name
*
Parent Cell #:
*
Ex: 816-321-4567 (include area code)
Parent E-mail:
*
Parent #2, Cell
Parent #2, E-mail
Club Reps Name / Signature:
Patty Reynolds
Provide the name of your CN team coach.
*
Provide Team Age Group
*
Example: 14U
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 team by your Coach's name so as to pay into the correct team.
Security Code
*
Use either Upper or Lowercase letters
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).