"*" indicates required fields Step 1 of 2 50% 2024 Goalie Training ProgramSelect Number of Sessions* 13 Sessions 2024 Goalie Training Program - $1365 - Best Value 12 Sessions 2024 Goalie Training Program - $1320 11 Sessions 2024 Goalie Training Program - $1210 10 Sessions 2024 Goalie Training Program - $1150 9 Sessions 2024 Goalie Training Program - $1035 8 Sessions 2024 Goalie Training Program - $960 7 Sessions 2024 Goalie Training Program - $840 6 Sessions 2024 Goalie Training Program - $720 5 Sessions 2024 Goalie Training Program - $600 Select a Level* Squirt/Peewee and 10U/12U Bantam/High School and 15U Select Dates for Squirt/Peewee and 10U/12U Level*If choosing 13 sessions, please check all boxes; otherwise, choose dates based on the number of sessions selected. Wed June 12 at 6-7pm Mon June 17 at 4:45-5:45pm Fri June 21 at 12:15-1:15pm Wed July 10 at 6-7pm Mon July 15 at 6-7pm Fri July 19 at 12:15-1:15pm Wed July 24 at 6:00-7:00pm Mon July 29 at 6:00-7:00pm Fri August 2 at 11am-12pm Wed August 7 at 1-2pm Wed August 14 at 2-3pm Mon August 19 at 1-2pm Fri August 23 at 12:15-1:15pm Select Dates for Bantam/High School and 15U Level*If choosing 13 sessions, please check all boxes; otherwise, choose dates based on the number of sessions selected. Mon June 10 at 4:45-5:45pm Fri June 14 at 2:45-3:45 pm Wed June 19 at 6-7pm Mon July 8 at 6-7pm Fri July 12 at 12:15-1:15pm Wed July 17 at 6-7pm Mon July 22 at 6:00-7:00pm Fri July 26 at 12:15-1:15pm Wed July 31 at 6-7pm Mon August 5 at 1-2pm Mon August 12 at 2:15-3:15pm Fri August 16 at 12-1pm We August 21 at 2-3pm Athlete InformationChild's First Name* Child's Last Name* Child's Date of Birth* Month Day Year Child's Gender*- Select One -MaleFemaleChild's Primary Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Medical conditions or allergies? (If yes, please explain)*2023-24 Team* Jersey Size*- Select One -Junior GoalieIntermediate GoalieSenior GoalieParent InformationPrimary Parent First Name* Primary Parent Last Name* Primary Parent Email Address* Primary Parent Cell Phone Number*Secondary Parent First Name Secondary Parent Last Name Secondary Parent Email Address Secondary Parent Cell Phone NumberEmergency Contact InformationEmergency Contact First Name* Emergency Contact Last Name* Emergency Contact Cell Phone Number*WaiverClick here to read the waiver.Consent* I acknowledge that I have read and understand the waiver.*Full Name*This serves as an electronic signature. Total Credit Card*Card Details Cardholder Name Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneThis field is for validation purposes and should be left unchanged. Δ
