REGISTRATION

Student Name:

Ten year old orange ball group, ten year old group, twelve year old group, fourteen year old group?

Gender:

Birth of Date:

School:

Future High School:

Parent or Legal Guardian Name:

Email:

Address:

Phone Number:

Emergency Contact Name

Relationship to Participant:

Phone Number:

I Have Read the Waiver and Release Forms I have read the exemption and authorization agreement (Please sign by tying your full legal name and current date) ：

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Registration information