Get Playing - Keep Playing Kids

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Application Form

Applications will be approved on a first come first serve basis. Keep Playing Kids will send a confirmation of approval if you have been approved. Please note you cannot attend programs unless you have received confirmation.

Child's Name *

First

Last

Birth Date *

Gender *

Male
Female
Prefer not to say

Parent/Guardian Name *

First

Last

Full Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number *

Email *

Emergency Contact *

First

Last

Emergency Contact Number *

Relationship to Child *

Does your child have any medical conditions/allergies? *

Yes
No

If yes, please detail below.

Does your child currently participate in any sport leagues/recreational activities? *

Yes
No

Does your child currently play on any extra-curricular school sports teams? *

Yes
No

Which of the following programs are you interested in? Please refer to Programs page for more information. Select all that apply. *

Ultimate Clinic - March 18, 2020
Soccer Clinic - March 27, 2020
Basketball Clinic - April 17, 2020
Ultimate Clinic - April 4, 2020

Refer to the Programs page for more information.

How did you hear about us? *

Phone

Keep Playing Kids