Program Registration Form

                                     Program Title_______________________ Day___________ Time___________ Session_____________ Level______________

                                    Participant's Name_____________________________ M or F   Grade_____    Birth Date___________

                                                                     Participant is a member OYes  ONo 

                                 Address_____________________ City____________________ State____________ Zip_________   Cell Phone__________________

                                Parent's Name (s) (if participant is a minor)________________________ Work Phone____________

                                                                I would like to volunteer   OYes     ONo   

                               In case of emergency, contact________________________ Day/Evening Phone__________________

                             *T-Shirts are included with some programs. (Circle the size) YS(6-8) YM(10-12) YL(14-16) AS  AM  AL  AXL