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Preregistration Form
Please complete the following application. Do not leave any space blank. If a space
does not apply to you please enter N/A. Thank you.
After School
Heritage Isles
 Grand Hampton
Seven Oaks
Club Tampa Palms
Date
Parents Name
Last
 First
Parents Name
Last
 First
Child's Name
 Age
Last
 First
Age
Last
 First
Age
Last
 First
Age
Last
 First
Address
Street
 City
State
Zip
Phone
Work
Home
 Cell
Area Code
 Area Code
 Area Code
Emergency
Contact
Home
Area Code
Last
 First
Someone other than yourself we can contact in case of emergency.
YL
S
M
L
XL
XXL
YL
S
M
L
XL
XXL
 Child's shirt size
Child's shirt size
Child's shirt size
Upon completion of this application a $65.00 deposit is required
to register your child. (first week fee)and if you have not
participated in our program for a year or first time a $50.00  
registration fee is required for each child. This will secure your
child's spot. Please send check or money order to:               
                                                           
Make check payable to:    PROtential Sports
                                  

Or pay with Credit Card over the phone
813.843.9460
Child's shirt size
After School
Camp
Email        example tom@aol.com
Email        example tom@aol.com
YL
S
M
L
XL
XXL
YL
S
M
L
XL
XXL
Please review your
answers and make
sure every space is
filled. Then submit.
2010