Untitled Document

I would like to register my child:	1st Sem Bus $40 2nd Sem Bus $40 Boys Basketball $40 Girls Basketball $30 Fall Volleyball $30 Spring Volleyball $30 Sp coed Soccer $30 Fa coed Soccer $30 Coed Biddyball $30 Summer Kidstop
	Primary Contact Information
Name:
Address:
City:
State:
Zip:
Phone:
Email:
	Child Information
Name:
Gender:
DOB:
Shirt Size:
	School Information
School:
Grade:
	Contact Information
Mother's Name:
Home#:
Work#:
Cell#:
Father's Name:
Home#:
Work#:
Cell#:
	Medical Information
Doctor Name:
Doctor#:
Premission to treat by doc/hospital:
Do you have insurance:
Any health Problems:
If yes, explain:
Medications:
If yes, explain:

	Other Information
Would you like to sponsor your child's team:
Sponsor name on shirt:
Special Notes or Requests: