Spring Season 2023 OPEN DAY

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Please ensure you register for OPEN DAY - April 01! Event available to players of all abilities for U10 (1st thru 4th grade) and U14 (5th thru 8th grade), running from 9-10:30am.

Also, please bring shinguards, a mouthguard, and your own water bottle. A stick shall be provided for you.

Please complete the registration.

Email Address of Registrant * Maximum of 100 characters

Full Name of Camper/Participant * Maximum of 100 characters

Name 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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