Next Level Performance Training

Participant's First Name

Parent/Guardian Name

Parent/Guardian E-mail

Date of birth

Emergency contact if different from parent/ Phone number

Medical Insurance Company

Policy Holder's Name

Medical Doctor's Name

I accept JGSC release/waiver

Participant's Last Name

Parent/Guardian Phone Number

Grade/Age

Name of School

Any restrictions on participation

Policy number

Relationship to Participant

Medical Doctor's Phone Number

I accept VK release/waiver

I accept COVID-19 release/waiver

Thank you for registering!