Pursuit Spring 2022 Whirlwind Program
Please Fill out this Google Form to register for Pursuit Spring 2022 4-Week Program
อีเมล *
Athlete Name (First & Last): *
Registering For (Select Program $350 per): *
Name of School and Grade: *
Age as of January 1, 2021 *
Birthdate: *
วว
/
ดด
/
ปปปป
USA Field Hockey Membership # and Expiration Date *
Shirt Size *
What Best Describes your Playing Experience? *
Parent / Guardian Names *
Parent / Guardian Email *
Mailing Address *
Phone Numbers (Cell & Home) *
Medical Insurance Information (Company & Policy #) *
Medical Concerns about Athlete that Coaches should know about?
Were you referred by Anyone?
Goals for your Pursuit?
Anything else you'd like us to know?!
Pursuit Field Hockey & Staff, take pictures and videos during events affiliated with the club. As a parent / legal guardian, I give my consent / do not give my consent (please choose below) that Pursuit may use such photographs or video of my daughter with or without her name, and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. *
By clicking SUBMIT you are agreeing to Pursuit Field Hockey, LLC Payment Disclosure Terms.Payment Disclosure:- All payments MUST BE submitted in full upon first session of program.- There is a $150 non-refundable deposit upon registration for ALL programs; the remaining balance can be paid off in two timely payments.​- Payments must be submitted as stated on Program’s Page.  Failure to do so in the timely manner will result in dismissal from program with no options of refunds. - ​There will be a $25 fee for any returned or bounced checks / payments. *
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