Registration

For first time registration click here.
For returning students click here to register.

“Break it Down” Total Sports Registration Form For children Ages 4-12 Years Old

Season *
Please choose the season you would like to register for:Basketball - Next Season, Agoura Hills, Cost is $450BaseballPlayground GamesSoccer
Child's Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Age *
Birthdate
Last Grade Completed
Sex
MaleFemale
Home Phone
Cell Phone
Work Phone
Email *
In Case Of Emergency
Please add name and phone number for 2 contacts.
Special Concerns (allergies, medications, medical conditions, etc.)
Persons Authorized to Pickup Child
Note: For safety and security, children will only be released to the persons listed above. Persons picking up children will be asked to provide picture identification. No children will be permitted to leave the premises without an adult on this list or without prior written approval.
Please read the statements below and mark yes or no
I give permission for my child to be photographed or videotaped for education/public information purposes to be posted on the company website.YesNo
NOTE Note: By submitting this form you will be placed on a list based on the order in which your information was received. "Break it Down" Total Sports will contact you to confirm that we have received your information, and will let you know whether we have an opening in your requested session (or another). Receipt of this form at "Break it Down" Total Sports does not guarantee placement in a session.

Returning registration Below!

Break It Down Total Sports