Little Trojans Registration

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The clinic registration fee is $125 for the first child and $85 for any siblings (please complete a separate form for each sibling). If paying by Venmo - @James-Rocco-13 If paying by check, please make checks payable to Jim Rocco 1013 Patrisa Export, PA 15632 .

Email *

Player First Name *

Player Last Name *

Grade *

1st

2nd

3rd

Required

Parent/Guardian Name *

Parent/Guardian Cell Number *

Parent/Guardian Email Address *

Secondary Contact Name (in case of emergency) *

Secondary Contact Cell Number (in case of emergency) *

SHIRT SIZE *

YXL

A XS

A S

A M

A L

PLEASE READ AND CHECK THE BOX BELOW *

BY CHECKING THIS BOX I AGREE TO THE ABOVE MEDICAL RELEASE AND WAIVER

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