Ambassadors Pittsburgh East End Registration
This form is to register for Ambassadors Pittsburgh East End Community Program. If you have any questions please email us at or call Matt Major at (412)770-6531.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Date of Birth *
Gender *
Child's School *
Your answer
What is your child's t-shirt size? *
Date of last tetanus shot: *
Your answer
Does your child have allergies to:
Does your child suffer from, or ever experienced, or is being currently treated for any of the following?
Additional Info:
Your answer
Are you registering more than one child? *
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