April Vacation Middle School Clinic

This is the registration & payment for the April Vacation Middle School Clinic.

DATES: Wednesday & Thursday, April 18th & 19th
TIMES: 12:15pm – 3:15pm
LOCATION: Maine Sports Arena, 15 Lund Rd, Saco, ME

Player Information

Player Name *

First

Last *

Last

DOB *

Best Email to Contact *

School Name *

Current Grade in School * 6 7 8 Other Current Grade in School

Years of Playing *

Maine Juniors Player? *

Yes

No

Which MJ Team? *

Current Position *

Libero/DS

Setter

Outside Hitter

Right Side Hitter

Middle Blocker

Current Secondary Position *

Libero/DS

Setter

Outside Hitter

Right Side Hitter

Middle Blocker

Medical Information

Please provide and explain any health concerns or allergies we should be aware of. *

(N/A if none)

Has the player had any recent injuries? If so, please explain. *

(N/A if none)

Primary Emergency Contact

Emergency Contact Name *

Cell Phone *

(999) 999-9999

Home Phone

(999) 999-9999

Second Emergency Contact

Emergency Contact Name *

Cell Phone *

(999) 999-9999

Home Phone

(999) 999-9999

Clinic Total

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