|
|
PARENT / GUARDIAN INFORMATION
|
|
PARTICIPANT INFORMATION
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Name
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
First Name
|
|
Legal Last Name
|
Name child prefers to be called
|
|
Work Phone
|
|
|
|
|
|
|
|
|
|
|
Gender
|
Male
|
|
|
Female
|
|
|
Home Phone
|
|
|
|
|
|
|
|
|
|
|
|
|
Cell Phone
|
|
|
School Attending
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Valid Email Address
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Physical Address
|
|
|
|
|
|
|
|
I, the Parent/Guardian of the child named here
do state that this child is
|
|
Date of Birth
|
|
|
|
|
|
|
|
|
How old will your child be on 08/01/10?
|
|
|
|
|
|
|
|
|
Yes, covered by an insurance policy
|
|
|
|
|
|
|
|
|
|
|
Any previous football/cheerleader
experience?
|
|
|
|
|
|
NOT covered by an insurance policy.
|
|
|
|
|
|
|
|
|
Yes, I am willing to Volunteer
|
|
|
|
|
No, my child wants to learn
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
No, I am not willing to Volunteer
|
|
|
|
|
Yes, my child has played or
cheered before
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2010Summer Camp On-line Registration
|
|
|
|
|
|
|
|
|
Shirt Size? YS, YM, YL, AS, AM, AL, AXL
|
|
|
|
Please be advised that there are no refunds and that all
uniforms and equipment are the property of the BCR
|
|
|
|
|
INITIAL YOUR ACCEPTANCE
|
|
|
|
|
|
|
|
|
How did you here about the Brush Country Rattlers
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Brush Country Rattlers 226 North St Pleasanton,
TX 78064 . You will be receving a confirmation via
email or by phone with in two days.
Call 210-421-1509 for more information.
|
|
|
|
|
