Training Center Registration
Child's First Name:
Child's Last Name:
Gender: Choose One Male Female
Age: 5 6 7 8 9 10 11 CHOOSE ONE
Date of Birth: January Month February March April May June July August September October November December 1 Day 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1995 1996 1997 1998 1999 2000 2001 2002 2003 2005 2006 Year
Parent's Name:
Phone:
Address:
City:
State:
Zip:
Email: (Required)
Session: FALL ONE TWO THREE FOUR
Ages 5-8 Classes: MON4PM MON5PM WED5PM THURS5PM CHOOSEONE
Ages 9-11 Classes: TUES5PM CHOOSE ONE WED6PM THURS6PM
Training Only Program:
T-Shirt Size: CHOOSEONE YOUTH MEDIUM YOUTH LARGE ADULT SMALL ADULT MEDIUM ADULT LARGE
Team: (For entire teams only; provide team name)
CALL: (413)543-8554)
SIGNATURE: