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[Tuesday] 23-24 Fall &Winter Classes@Tillicum
Thank you for joining Jp Sports Clinic!!
Time : 5~6pm
Place : Tillicum Pearkes Rec Center(3100 Tillicum Rd, Victoria, BC V9A 6T2)
Contact: 778 533 2848 or
jpsportsclinic@gmail.com
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Player Information
Family Name
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First Name
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Age
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Gender
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Birthday
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Your answer
School Name
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Grade
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Dominant foot
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Right
Left
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Special Notes & Requests (Allergies, medication, or special needs etc. if any)
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I Information
Family Name
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First Name
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Relationship to Student
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Address
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Phone
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Email
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Emergency Contacts
#1 Name / Relationship / Phone
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#2 Name / Relationship / Phone
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Please check a box if you agree
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The lesson fee is $20 each lesson per parson. You will make a fee payment once a month with e-transfer
Cancel fee: When players need to absent a lesson via self-convenience such as sickness, family matter, and so on, we receive a half lesson fee, $10 each. (When you notice before 1 month, there will be no cancellation fee)
Sibling discount: When a player has siblings and they participate together, we discount $5 per sibling in each session.
Introduction discount: When you introduce a new player for us, we deduct $20 per new player from a monthly lesson fee.
You also can attend 2 times in a week, in that case, you will be charge $20 per a week and no Sibling discount and Cancel fee
Required
☝︎Our lesson fee * please read carefully☝︎
Photo use approval
By checking a box, I give consent for interviews, photographs or videos of my child to be used on websites or publications by JP Sports Clinic.
Insurance policy
When you send this registration form to us, a player will join automatically our insurance up to $2M coverage
Please Download our communication tool !! We prefer you to download communicate application called "BAND". It will make you can see the contents of practice and practice picture or movie. Please download from this URL or QR code, Thanks https://band.us/n/a3a563SaQbv51
A copy of your responses will be emailed to the address you provided.
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