HLREG#2_B

"GET IN THE GAME" REGISTRATION FOR TWO

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* Indicates required field

Location *

PARTICIPANT #1 INFORMATION:

Participant #1 Full Name *

First

Last

D.O.B (mm/dd/yyyy) *

Phone Number *

Grade *

Name of school currently attending *

Position *

Height *

T-shirt size *

Participant #1 Email *

PARTICIPANT #2 INFORMATION:

Participant #2 Full Name *

First

Last

D.O.B (mm/dd/yyyy) *

Phone Number *

Grade *

Name of school currently attending *

Position *

Height *

T-shirt size *

Participant #2 Email *

PARENT INFORMATION:

Parent Name: *

Parent Email *

Street Address *

Apt#/Suite# *

City *

Province *

Postal Code *

EMERGENCY INFORMATION:

Emergency Contact Name *

First

Last

State relationship *

Phone Number *

Please specify any medical conditions: *

If your daughter has any allergies, she must be equipped with an epi-pen at all times.

If your daughter is asthmatic, she must be equipped with a puffer at all times.

Failure to meet these safety conditions will result in the removal of your daughter's participation for that day. NO REFUNDS.

PAYMENT INFORMATION:
Please indicate how you will be paying.

Payment Options *

Enter Promo Code: *

**Please note a cancellation fee of $40 per transaction will be withheld.

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