Program Registration

Program Registration and Payment

After filling in the registration, you will be prompted for credit card payment at the bottom.

Athlete

Birth date*

Gender*

Age at Program Date*

Please enter a number from 2 to 20.

Grade in Fall

School in Fall

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Athlete's Email

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Athlete's Cell Phone

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USATF Number

Player Position

Please indicate Gender and Birth year as "F2006" for example.

Allergies/Medical Conditions*

Please list any allergies or medical conditions. Enter "None" if there are not any to list.

Doctor*

Insurance Provider*

Medical Insurance

Insurance Member ID*

Medical Insurance ID Number

Parent/Guardian Information

Parent/Guardian Email*

Parent/Guardian Phone*

Additional emergency contacts, when I cannot be reached:

In addition to those already listed above, an additional contact is required by the State of Colorado Department of Childcare. The following has my permission to sign my child out from the program and may be contacted in an emergency in case I cannot be reached.

Relationship*

Emergency Contact eMail*

Emergency Contact Phone*

Liability Waiver

Please review the Liability Waiver

Check Out Total:

Registration Page