Registration Form
Please fill in each field
First Name *
Your answer
Last Name *
Your answer
Athletes Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Your answer
Gender *
Parent 1 First Name *
Your answer
Parent 1 Last Name *
Your answer
Parent 1 Email Address *
Your answer
Parent 1 Address *
Your answer
City
Your answer
State
Your answer
Zip Code *
Your answer
Parent 2 First Name
Your answer
Parent 2 Last Name
Your answer
Parent 2 Email Address
Your answer
Parent 2 Address (if applicable)
Your answer
Name of Medical Provider *
Your answer
Insurance Policy # *
Your answer
Name of Family Doctor *
Your answer
Singlet Size (Only if choosing the USAW Option)
T- Shirt Size *
Pay Online Here (or chose pay by check or cash) *
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