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"*" indicates required fields

Child Name*

Child Age*

Date of Birth*

Sex*

Child's T-shirt Size*

School Child Attends (if applicable)

Emergency Contact Name:*

Emergency Contact Phone:*

Who is authorized to pick up your child?:*

Please enter the names of people who are authorized to pick up your child or children and their relationship, one per line.

Parent Name*

Parent Email*

Parent Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Payment Options (please select one)*