U14 Fall Season 2022

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$280.00

$200.00 - $280.00

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per item

What a fantastic season we have ahead of us! Our inaugural U14/Middle School fall program sees players coming together from across the Badger State (and one from Illinois) to represent the 'Burners against regional field hockey programs.

We're offering full (>10 sessions) and half (<10 sessions) rates as well as providing sibling discounts! Club rule, you must attend the practice prior to any scheduled games in order to be eligible to start!!!

Fees cover field hire, 1 x official team jersey etc. etc.

Finally, please ensure you provide your top three preferences for shirt number!!! We'll do all we can to provide your primary!

Shirt Number Preference (please list three) Maximum of 20 characters

Full Name of Camper/Participant * Maximum of 100 characters

Name of Registrant * Maximum of 100 characters

Email Address of Registrant * Maximum of 100 characters

Emergency Contract # * Maximum of 12 characters

Street Address * Maximum of 100 characters

Address Line 2 Maximum of 100 characters

City, State, & ZIP * Maximum of 100 characters

Medical Insurance (MI) Provider Name * Maximum of 100 characters

MI Member Name * Maximum of 100 characters

MI Member ID # * Maximum of 20 characters

MI Group # Maximum of 20 characters

Medical issue staff need to be aware of: Select all that apply Yes No

(if checked, please provide necessary information below) Maximum of 100 characters

*I have read and agree to abide by Cheeseburners Field Hockey Club Code of Conduct Select all that apply Yes No

*I agree with the DECLARATION OF GOOD PHYSICAL CONDITION & CONSENT TO EMERGENCY MEDICAL TREATMENT shown below. Select all that apply Yes No

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