USYS Goalkeeper Club Registration - Monthly - Keeper Wars Ink

USYS Goalkeeper Club Registration - Monthly Subscription

WELCOME TO THE GOALKEEPER CLUB!

We are thrilled to have you join our GK Club & Community!
We recommend you do Not use autofill for this form. Please read all instructions carefully.
Membership is not active until payment has been received.

MONTHLY PAYMENT PLAN - $37/mo - $37 billed every month

Goalkeeper Information

GK First Name

GK Last Name

Age

Birthdate

What City do you live in?

If you live outside of the U.S., tell us where.

How many years have you played goalkeeper?

Team Name

Club Name

GK Training

Fitness

Your understanding of exercise

On a scale 1-10 (10 being excellent & 1 being none)

Your exercise habits

On a scale 1-10 (10 being excellent & 1 being none)

Your willingness to exercise better

On a scale 1-10 (10 being excellent & 1 being none)

Nutrition

Your understanding of nutrition

On a scale 1-10 (10 being excellent & 1 being none)

Your nutrition habits

On a scale 1-10 (10 being excellent & 1 being none)

Your willingness to eat better

On a scale 1-10 (10 being excellent & 1 being none)

Performance & Mindset

How confident are you in yourself?

On a scale 1-10 (10 being excellent & 1 being none)

How well do you handle the pressures of being a goalkeeper?

On a scale 1-10 (10 being excellent & 1 being none)

Parent/Guardian Information

Parent First Name

Parent Last Name

Phone

Primary Email

Secondary Email

Address Line 1

Address Line 2

City

State

ZIP/Postal Code

Country

WAIVERS

Please read the following documents.

Keeper Wars Ink, LLC Goalkeeper Club Code of Conduct

Keeper Wars Ink, LLC Photo/Video Release

I have read and accept the above documents.

Yes

Adult or Guardian Signature

*Sign here to acknowledge that you have read and consent to the release and waivers shown above, in their entirety.

How did you hear about us?

*For office use only

Member Access / Subscriber Information

Please save the information you fill out below.
This will be your username & password to access the private membership content!

First Name

*If under 13, must be a Parent/Guardian Name

Last Name

*If under 13, must be a Parent/Guardian Name

City

Email

*Your email will be your Username.

Password

MONTHLY PAYMENT PLAN - $37/mo - $37 billed every month (Can cancel at anytime.)

You will be redirected to Paypal to begin your subscription. *You do Not need a Paypal account.

*Membership is not active until payment has been received. We can't wait to meet you!

Payment

Discount

Subtotal

Tax

Total USD