Savage Women's 2016
First Name * *
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Last Name * *
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Age *
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Grade (in Sept 2016) * *
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High School * *
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Email *
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Can you attend Misfit Cup? (June 25/26) * *
Can you attend BCUC's? (July 16/17) * *
Can you attend Nationals in Edmonton? (August 6-11th) * *
What days will you be away this summer, if any? Please explain why and give dates. Please keep explanations short. (Ex. Family vacation June 25-29)
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Emergency Contact Name *
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Emergency Contact Phone Number *
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