First Name:

Last Name:

E-Mail:

Home Phone

Player is a

Select One
CTK
CKS
BOTH
OTHR

For Grade: P1 will play up to grades 1 and 2.

Select One
PK
K
P1
1
2

Gender

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M
F

Shirt Size

Select One
YS
YM
YL
AS
AM

Days of the week and times player CANNOT practice and reason

Father's Name

Father's Cell Phone

Mother's Name

Mother's Cell Phone

Parent/Guardian Signature (approval for the participation as explained in the info page)

Date

Pricing Options
PKand K $115
1 and 2 $130

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