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PicklePlayground Clinic Registration
Parent's email (will be used for correspondence)
*
Parent's name
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Parent's phone
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Child's name
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Child's age (at time of clinic)
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Emergency contact name and phone number
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Friends at the clinic
Please give details of allergies, who is authorized to pick up child at end of day, and any other special considerations.
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Clinic sign-up
Ages 5-8
Ages 8-13
Bessborough Drive Elementary School
(Saturdays, May 2-Jun 6) (6 sessions)
Rosedale Jr. Public School
(Sundays, May 3-Jun 14), in partnership with Mooredale (7 sessions)
Hillcrest Community School
(Saturdays, May 2-Jun 6) (6 sessions)
Total $
Photo/Video Release:
This year PicklePlayground will be filming a promotional highlights video for use by PicklePlayground. I understand that my child may appear in this video or photos. Please email Jeremy if this presents a concern. Jeremy sincerely appreciates your support, as it helps his business grow and allows him to share the joy of pickleball with others.
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Photo release
I agree
How did you hear about us?
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Mooredale members, please choose 'Mooredale'
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