CrossTimbers Registration 2018 - 7/20-23/18
Email address *
$25 Deposit or $75 Total Fee To Complete Registration
Child's First Name *
Your answer
Child's Last Name *
Your answer
Date of Birth *
MM
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DD
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YYYY
Gender *
Age *
Your answer
Grade Completed *
T-Shirt Size *
Address *
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City *
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State *
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Zip *
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In Emergency Notify *
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Relationship
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Call This Phone # *
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Work Phone #
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Secondary Emergency Contact *
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Secondary Emergency Contact Phone # *
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Any Known Allerigies? *
If Allergies Please List Them
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Payment (Online Link in Email Receipt) *
A copy of your responses will be emailed to the address you provided.
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