Introduction
Last Name: First:
Address:
City: Zip Code:
Home / Cell Phone: /
E-mail Address:
Father Name:
Father Contact Info:
Mother Name:
Mother Contact Info:
Secondary Address:
City: Zip Code:
Best Family Email:
(Please print very legibly--to ensure correct address)
Physical completed (circle one): YES NO
Gold Card Money paid (circle one): YES NO
Internet Web Page Permission Form: Athlete Signature:
Parent's Signature/Date:
Safety Contract: Athlete Signature:
Parent's Signature/Date:
Guide Book Read: Athlete Signature:
Parent's Signature/Date:




