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Upcoming Clinics

June 11, 2011
July 23, 2011

Clinics will be located at Bud’s Place – 9719 Green Park Industrial Drive St. Louis Mo. 64123 | MAP

Fees: $30.00 per clinic or $50.00 for both clinics on the same day.
(checks should be made out to Broderick A. Pritchett)

Name:   Phone:
Address: Email:
City:
State: Zip:
 
Grade: Birthdate:
Gender:  Male Female Age:
 
Primary Position:  OH MB RH Setter Libero/DS
 
Saturday, June 11th
Clinic(s) Attending:  Defense 6/11 (10am-12pm) Offense 6/11 (1pm-3pm) 6/11 Both
 
Saturday, July 23rd
Clinic(s) Attending:  Defense 7/23 (10am-12pm) Offense 7/23 (1pm-3pm)  7/23 Both
 
 I hereby authorize the directors of Club Inferno to act for me according to their best judgement in any emergency requiring medical attention. I will be responsible for all medical or any other charges related to attending any Club Inferno activity. I hereby release Club Inferno directors, instructors, volunteers or any others involved in this activity from all liability for loss, damage or injury whether caused by negligence or otherwise while my child is participating in any Club Inferno activity.
 
Parent or Guardian Email:
Emergency Phone Number:

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