Introduction to Game Speed Athletes Name: Age: DOB (mm/dd/yy): Address: Street Address City State / Province / Region Postal / Zip Code Parent(s) / Legal Guardian Name: Home Phone: Area Code - Phone Number Cell Phone: Area Code - Phone Number Parents E-mail: Emergency Contact: Emergency Contact Phone: Area Code - Phone Number Select Option:$159 - 16 Sessions$99 - 1 Month$15 - Drop In ClassSubmitResetAfter completing this form, you will be redirected to our Release of Liability Form. Please print and sign, and bring in with your payment to EXSP. Thank you!