Registration

Toddler Sports Academy

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2011 Registration Form

Toddler Sports Academy Registration Form
Please print out and mail to: 1550 45th Ave. Capitola, CA 95010

Player 1 __________________________ Male/Female Birthdate ______/______/______
Circle one
Player 2 __________________________ Male/Female Birthdate ______/_____/_______
Circle one

Parent(s) Name __________________________ Home Phone________________________

Home Address__________________________ City___________________ Zip_________

Cell Phone__________________________ Additional Phone________________________

E-mail Address______________________________@__________________________

Preferred Method of Contact: E-mail Home Phone Cell Phone Additional Phone
Circle One

Emergency Contact __________________________ Phone______________________

Class Selections for Fall 2011
*Please be sure to use the schedule to enroll your child in the proper class/day/time.

Choice #1 ____________________________ _________________________
Day of the week Time
Choice #2 ____________________________ _________________________
Day of the week Time

The 6 week session is $90.
One-time registration fee of $25 per child for new participants, includes a child's T-shirt.
Siblings receive $10 off per child(Can not be combined with any other offer)
Multi Class Discount $20 off the second class during the same session (Can not be combined).
Class size minimum of 8 - otherwise session will be cancelled and money will be refunded.
Please make checks payable to: Toddler Sports Academy

I, the undersigned participant, parent, or guardian, do hereby agree to participate and/or allow
the individual(s) named herein to participate in the aforementioned activity(ies) and further agree
to indemnify and hold harmless Josh Schelhorse, Toddler Sports Academy, its agents and
employees from harm, accidents, personal injury or property damage which may be suffered
by the aforementioned individual(s) arising out of, or in any way connected with the participation
of the activity.

_________________________________________________________________________
Signature                                                                                                          Date

Mail Registration form and payment to:           Toddler Sports Academy
   1550 45^th Ave.
   Capitola, CA 95010

Additional information can be obtained by e-mailing us at:
toddlersportsacademy@yahoo.com
or calling us at
(831) 706-0552

* Discounts may not be combined with any other special offers or discounts.