Midcoast April Clinics Registration This clinic is for girls grades 8-11 with all experience levels! COST: $20 per clinic or attend both for $35! DATES: April 22 & April 29 TIME: 1-3 PM LOCATION: Bath YMCA – 303 Centre Street, Bath Player Information Player Name * First Last * Last DOB * Best Email to Contact * School Name * Current Grade in School * 9 10 11 12 Other Current Grade in School Years of Playing (0 is ok) * Have you participated a Maine Juniors event before? * No YesYes If Yes, which event? 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 Select your clinic(s). * April 22 - $20 April 29 - $20 Calculate Total Discount for both clinics Clinic Total reCAPTCHA If you are human, leave this field blank.