Participant Registration Form

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Thank you for filling our CGOA's online participant registration form! All of the information on this form is confidential, and is necessary in order to provide adaptive recreation programming for individuals with disabilities.

Participant Contact Information

What school or agency are you with?

First Name *

Last Name *

Phone Number *

Email Address

Address *

City *

State *

Zip Code *

Date of Birth

YYYY

Age *

Height

Weight

Gender

Male

Female

Prefer not to say

Other:

Clear selection

Are you your own legal guardian? *

Yes

Clear form

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