Name *

First Name

Last Name

Phone *

(###)

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T-Shirt Size *

Youth 14/16

Adult Small

Adult Medium

Adult Large

Adult XL

Adult XXL

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

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Father's Cell or Work #

(###)

###

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Mother's Cell or Work #

(###)

###

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Emergency Contact Phone *

(###)

###

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Doctor's Phone *

(###)

###

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Parent or Guardian Signature *

I affirm that I am the legal parent or guardian and that I filled out/affirm the information on this form.