James River Regiment 2017-2018 Registration
Please complete the following information if you are interested in joining the James River Regiment for the 2017-2018 Season.
Last Name:
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First Name:
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Instrument:
Home Address:
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City:
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State:
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Zip Code:
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Grade for the 2017-2018 School Year
Home Phone Number:
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Students Email Address:
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Students Cell Phone Number:
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Parents Names:
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Parents Email Address #1:
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Parents Email Address #2:
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Parents Email Address #3:
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Parents Cell Phone Number #1:
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Parents Cell Phone Number #2
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Parents Work Number:
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In Case of Emergency, Please Contact: Name & Number:
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