ST PATRICK SCHOOL KENT - CYO ATHLETIC REGISTRATION FORM-Cross Country
PLEASE COMPLETE THE ENTIRE FORM. YOUR REGISTRATION CANNOT BE ACCEPTED IF ANY OF THE REQUIRED FIELDS ARE LEFT BLANK .

REGISTRATION REQUIRES COMPLETION OF PRE-PARTICIPATION FORM AND HOLD HARMLESS AGREEMENT. BOTH OF THESE FORMS ARE AVAILABLE AT http://www.stpatskent.org/cyo-athletics/cyo-general-info (scroll down to Downloads & Documents)

Athlete First Name *
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Athlete Last Name *
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Athlete Gender *
Grade *
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Guardian Name *
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Guardian Street Address *
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Guardian City *
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Guardian State *
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Guardian Zip Code *
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Guardian Home Phone *
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Guardian Work Phone
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Work Phone Extension
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Guardian Mobile Phone
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Guardian E-mail *
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Athlete Birthdate *
Month/Day/Year
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Athlete County of Residence *
Athlete Religion *
Athlete Race *
Athlete Eligibility *
Athlete Physical Exam Date *
Month/Day/Year
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Athlete School *
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Athlete Parish *
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By submitting this registration, I agree to all fees associated with this sport including but not limited to participation fee, booster fee and uniform deposit
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