Event Name: 2013 Wednesday Night HS Girls Boot Clinic
Entry Fee: $199.00
Participant Information
First Name:
Last Name:
Date of Birth: MM/DD/YYYY
Shirt Size:
Shirt Number: only digits 1-5 (i.e. 1-5, 11-15, 21-25, etc)
Parent/Guardian Information
First Name:
Last Name:
Email Address:
Zip Code: 5 Digits
Emergency Phone:
Where did you
hear about this
E-mail Newsletter
Mailed Brochure
Newspaper Ad/Article
At the Facility
TV AD During Celtics Game
Payment Information
Card Number: Only
Name On Card:
Expiration Date:
Payment Amount: Example: 99.99
Billing Zip: 5 Digits

By submitting this registration you understand that any participants attending the programs and using Mass Premier Courts, LLC facilities does so at his/her own risk. Mass Premier Courts and its owners, employees or agents, shall not be liable for any damage whatsoever arising from any personal injury or property loss sustained by participant with his/her family in or about any programs on the premises. Participants and parents assume full responsibility for all injuries and damages which occur in or about any programs on the premises, He/She does hereby fully and forever release discharged hold harmless "Mass Premier Courts, LLC", all associated facilities and its owner, employees, and agents from any and all claims, demands, damages or rights of action, present or future resulting from any person's participation in any programs or use of the facility. In addition, he/she agree(s) to follow the rules of conduct and play set by Mass Premier Courts, LLC. Failure to do so may result in suspension from participation. Consent: I the undersigned parent or guardian/participant do hereby grant authority to the staff at Mass Premier Courts to render a judgment concerning medical assistance or hospital care in the event of an accident or illness during my absence. I do hereby authorize "Mass Premier Courts and its assigns to utilize any and all photographs, pictures or other likeness of me or anyone assigned guardianship to me, as they deem appropriate in its promotional materials or team films.

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(Note: There are no refunds.)