Boys Club Registration - 2019-20
Email address *
Name of Child - first, last *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Grade *
Home Church (if any)
Your answer
Parent / Guardian *
Your answer
Parent / Guardian
Your answer
T-shirt Size (youth) *
Home Address *
Your answer
cell # *
Your answer
cell #
Your answer
in case of emergency call *
Your answer
phone # *
Your answer
Allergies (if none, write 'none') *
Your answer
Medications (if none, write 'none') *
Your answer
Dietary restrictions (if none, write 'none') *
Your answer
Health Card Number *
Your answer
Volunteering
Permission to Participate *
Required
Permission to Photograph *
Required
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