Dr John's Sports Center: Space Reservation

To reserve a space in one of our upcoming programs, please complete the online form for each participant or child. We will contact you with information regarding availability and program costs. To finalize your reservation in one of our programs, payment must be received by our office prior to the beginning of the event.

Electronic Communications with Dr. John’s Sports Center: We at Dr. John’s Sports Center do not intend to collect information from children who are under 18 years of age. If you are under 18, your parent or guardian should be the individuals providing information on the Space Reservation form.

Parents: When you visit drjohnssportscenter.com, send us emails or submit an online reservation, you are communicating with us electronically and consenting to receive communications from us electronically. We may communicate with you by email or by posting notices on this website. You agree that all notices, disclosures, agreements or other communications we provide electronically satisfy any legal requirement that such communications be in writing.

Download Dr. John's Privacy Policy. Back to Program Information Page

Space Reservation

Participant's First Name *

Participant's Last Name *

Participant's Date of Birth (mm/dd/yy) *

Participant's Grade in School *

Participant's Sex *

Male Female

Participant's Home Address *

Participant's City *

Participant's Zip Code *

Participant'sT-Shirt Size

Parent or Guardian's First Name

Parent or Guardian's Last Name

Participant's Home Phone (used as family account number) *

Daytime Phone for Adult Participant or Parent/Guardian of Child *

Adult Participant or Parent/Guardian's Cell Phone

Email Address for Confirmation *

Name of Participant's School

Emergency Contact Name

Emergency Contact Phone Number

Child Care Program

Recreation & Special Events

How did you hear about Dr. John's Sports Center?

May we add your email address to our monthly Dr. John's Corner Newsletter?

Yes No

May we contact you to be Volunteer or Coach for our children's Recreation Leagues?

Yes No

Team or Coach Request

In this sport, my child has:

Few skills Moderate skills Adv. skills

If your child is taking any medications or has any medical condition that coaches, staff, etc. should be aware of or that could affect his/her participation, please list below.

Comments

Please be patient, form submission takes a second to respond. Thank you!

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