Child Information
Child Name:
Child Grade:	- Choose an Option - 3 4 5 6 7 8 9 10 11 12
School Attending:
Parent Name
Address (include city)
Parent Cell Phone Number:
Parent Email Address(es)

Requested Information
Child Date of Birth
Child Gender	- Choose an Option - M F
Most Recent Team Played on
Preferred Payment Method	- Choose an Option - VENMO app PayPal App Pay in person at gym Check to 61 Oleander Drive Northport 11768
Please look for email charging preferred payment method listed. Additional comments:

Additional Info
Text OK to contact	- Choose an Option - Yes No