Summer Registration

Name
Birth Date:
 / 
 / 
Gender :
E-mail*
Parents/Guardians Name :
Address
T-Shirt Size (Jersey Size) :

EMERGENCY CONTACT:

Name :
Relationship To Player :
Phone :
-
E-mail:
Camp Location:
Camp Date:
Camp Time:
 : 
Amount:
 $ 
 . 
Consent (Signature) :*

Sponsors

  chesroc  Peculiar Royalty Harris Consult