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International
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Training Programs

ONLINE GROUP REGISTRATION
* = Required Information
PERSONAL INFORMATION
*Applicant's Name: Last First
*Address: Street
  City State Zip
Phone: *home phone   work / cel phone
*Email Address:
Other: T-shirt size Gender
Applicant type: Coach  
ADDITIONAL INFORMATION
Main areas of interest: Basic Skills Speed Coach's Training Freestyle/Fusion
Roommate Request (Name)

GROUP/TEAM INFORMATION
COACHES REGISTERING A GROUP PLEASE FILL OUT THIS SECTION

Coach's Name: Last First
Team Name:
Organization Name: (if applicable)
City State
*Number of persons attending:  
TEAM MEMBERS INFORMATION
Please type team members' names and grades (next fall) below.
  • Each team member must submit a separate application form with signed parental consent.
  • Deposit payments for coach and each team members are due June 15, 2010.
  • Coaches may pay for part of, or all of their group, or just for themselves after submitting this form.
CONSENT
By checking "I consent" below, I certify that I am over 18 years of age and hereby authorize the directors and agents of the National Double Dutch League to act in my behalf using their best judgement in any emergency, including medical emergency. I hearby waive and release the League, Camp, its employees, volunteers, directors, sponsors, suppliers, and facilities from any and all liability for illness or injury incurred while attending the Double Dutch Camp. I know of no mental of physical problems that might adversely affect my ability to participate in this Camp. I hereby grant NDDL permission to use any photographs or video of me/my team for promotional purposes. I have read the information in the NDDL Camp brochure and agree to its terms and conditions, including the refund policy.
I have read the above and give my consent:  
Submit this form and continue to the payment page>>  
   


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