Register with Roy D Performance Coaching Player's Name * First Name Last Name Date of Birth * MM DD YYYY Medical Conditions Please leave blank if not relevant. Parent/Caregiver Name First Name Last Name Phone * Please display like the following examples: (09) ### #### or 027 ### #### (###) ### #### Email * Service * Please select the service you would like. Select Service Type 1on1 Coaching Strength & Conditioning Youth Development Online Programs & Mentoring Do you consent to photos/videos being taken? Yes No How did you hear about us? * Existing or Returning Player Word of Mouth Instagram TikTok Facebook Youtube Other (Please Specify Below) If you selected 'Other', please specify here. Message Please provide any additional information you would like to share in the textbox below. Thank you! We will be in touch with you shortly.
