AM 2 PM
Registration Form
Name *
Enter participant's full name
Your answer
Date Of Birth *
Enter participant's date of birth (mm/dd/yyyy)
Your answer
Gender *
Enter participant's gender
Your answer
School/Church *
Enter the school or church with which the participant is affiliated
Your answer
Address *
Enter the participant's home address: Street, City, State, Zipcode
Your answer
Shirt Size *
Choose your preferred shirt size
Required
Persons with Disabilities
List any accommodations needed
Your answer
Health Concerns
Specify any of the participant's health concerns that we should know about.
Your answer
Medication
Specify any medication the participant takes that we should know about.
Your answer
Parent/Guardian Name *
Enter parent/guardian's full name
Your answer
Parent/Guardian Contact Number *
Enter parent/guardian's cell phone number
Your answer
Emergency Contact *
Enter emergency contact information: Name, Relationship, Phone Number
Your answer
Dismissal Arrangements
Enter the full name(s) of anyone other than the guardian who is authorized to pick up the participant. Also list any other dismissal arrangements in the space provided
Your answer
Alternative Lunch/Dinner *
Will the participant be bringing their own lunch/dinner? If so, please be sure that the food is clearly marked using their full name. A refrigerator will be available for storage and a microwave to warm it up, if necessary.
Required
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