PLEASE FILL IN AS COMPLETELY AS POSSIBLE.

SELECT CAMP DETAILS:     (Choose all that apply:)
—Please choose an option—Nov 23 - Nov 25 (M-W) - Thanksgiving - All SportDec 21 - Dec 23 (M-W) - Christmas - All SportsDec 28 - Dec 30 (M-W) - Winter - All Sport or Baseball/SoftballMar 7 - Mar 11 (M-F) - Spring Break 1 - All Sport or Baseball/SoftballMar 14 - Mar 18 (M-F) - Spring Break 2 - All SportsJun 6 - Jun 10 (M-F) - Summer 1 - All Sport or Baseball/SoftballJun 13 - Jun 17 (M-F) - Summer 2 - All SportsJun 20 - Jun 24 (M-F) - Summer 3 - All Sport or Baseball/SoftballJun 27 - Jul 1 (M-F) - Summer 4 - All SportsJul 11 - Jul 15 (M-F) - Summer 5 - All Sport or Baseball/SoftballJul 18 - Jul 22 (M-F) - Summer 6 - All SportsJul 25 - Jul 29 (M-F) - Summer 7 - All Sport, Soccer or Baseball/SoftballAug 1 - Aug 5 (M-F) - Summer 8 - All SportsAug 8 - Aug 12 (M-F) - Summer 9 - All Sport or Baseball/SoftballAug 15 - Aug 19 (M-F) - Summer 10 - All Sports—Please choose an option—All SportsSoccerBaseballSoftball—Please choose an option—1 Day2 Days3 Days4 Days5 DaysMoTuWeThFr—Please choose an option—All Day9am - 12pm1pm - 4pm      Client Type: —Please choose an option—MemberNon-Member

PLAYER INFORMATION

Full Name:    Gender: —Please choose an option—MaleFemale     Age:    DOB (M/D/Y): —Please choose an option—123456789101112 / —Please choose an option—123345678910111213141516171819202122232425262728293031 / —Please choose an option—20112010200920082007200620052004200320022001

Street Address:    City:    State: TXALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY    Zip:

Phone:    Grade: —Please choose an option—K1st2nd3rd4th5th6th7th8th    School:

Height:    Weight:    Shirt Size: —Please choose an option—Y-XXSY-XSY-SMY-MDY-LGY-XLSMMDLGXLXXL

League:    Division:    Team:    Coach:

PARENT/GUARDIAN 1 INFORMATION     (Must be 18 or older)

—Please choose an option—FatherMotherGrandfatherGrandmotherUncleAuntGuardian    Gender: —Please choose an option—MaleFemale    Age:    Date of Birth:

Full Name:    Email:

Home Phone:    Mobile Phone:    Work Phone:

Same Address As Player: YesNo   -   If address is the same as PLAYER'S, leave address fields blank.

Street Address:    City:    State: TXALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY    Zip:

PARENT/GUARDIAN 2 INFORMATION     (Must be 18 or older)

—Please choose an option—FatherMotherGrandfatherGrandmotherUncleAuntGuardian    Gender: —Please choose an option—MaleFemale    Age:    Date of Birth:

Full Name:    Email:

Home Phone:    Mobile Phone:    Work Phone:

Same Address As Player: YesNo   -   If address is the same as PLAYER'S, leave address fields blank.

Street Address:    City:    State: TXALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY    Zip:

EMERGENCY INFORMATION     (Must be 18 or older)

Full Name:    Relation:    Email:

Home Phone:    Mobile Phone:    Work Phone:

Are there any special needs or requirements or anything else you'd like us to know?

How did you learn about us?

NL Player receiving credit for the FUND-A-FRIEND DISCOUNT?

INSURANCE & LIABILITY INFORMATION     (Must agree in order to register.)
All coaches, parents and parents of players must provide at own expense any insurance deemed necessary. NEXT LEVEL SPORTS GROUP (NLSG) DOES NOT PROVIDE ANY PERSONAL INJURY OR LIABILITY INSURANCE WHATSOEVER. I waive and release NLSG and any other facility used for the clinics, schools or camps from any injury or illness incurred while attending any NLSG clinics, schools or camps, as well as personal, group or team trainings. I hereby give my permission to allow NLSG coaches or staff to administer emergency medical treatment in the event that I cannot be reached.

I HAVE READ AND AGREE TO THE TERMS, CONDITIONS AND COVENANT WITHIN IT, INCLUDING BUT NOT LIMITING TO THE MINOR RELEASE AND THE WAIVER OF LIABILITY:  RELEASE & AGREEMENT

Agreed to by (your full name): Email: