"*" indicates required fields Step 1 of 2 50% Next Level Scoring Skills ProgramSelect a Level* 2024 Scoring Skills Program Squirt/10U Level - $745 2024 Scoring Skills Program Peewee/12U Level - $745 2024 Scoring Skills Program Bantam/15U/High School Level - $745 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)*Player Position* 2023-24 Team* Jersey Size*- Select One -Junior XSJunior S/MJunior L/XLSenior SmallSenior MediumSenior LargeSenior XLParent 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 CommentsThis field is for validation purposes and should be left unchanged. Δ
