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YOUTH
Parent/Guardian Name
*
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Cell Number
Email
How many child do you need to register?
1
2
3
4
Child #1
Child #1
*
First
Last
Birth date
MM slash DD slash YYYY
Grade entering in the Fall
Medical Information we need to know
T-Shirt Size
Youth Small 6-8
Youth Med (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
(choose one of the following)
Child #2
Child #2
*
First
Last
Birth date
MM slash DD slash YYYY
Grade entering in the Fall
Medical Information we need to know
T-Shirt Size
Youth Small 6-8
Youth Med (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
(choose one of the following)
Child #3
Child #3
*
First
Last
Birth date
MM slash DD slash YYYY
Grade entering in the Fall
Medical Information we need to know
T-Shirt Size
Youth Small 6-8
Youth Med (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
(choose one of the following)
Child #4
Child #4
*
First
Last
Birth date
MM slash DD slash YYYY
Medical Information we need to know
Grade entering in the Fall
T-Shirt Size
Youth Small 6-8
Youth Med (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
(choose one of the following)
May we have permission to photograph your child for the purpose of promotion?
Yes
No
