Athlete's Name *

First Name

Last Name

Athlete's Birthday *

Child must turn 13 after August 1st

MM

DD

YYYY

Parent/Guardian *

First Name

Last Name

Phone *

(###)

###

####

Checkbox *

Male

Female

Does your child have a state issued ID. *

Identification Card from the Department of Motor Vehicles (Required for Eligibility)

Yes

No