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Parents:     Child:       Child DOB:  
Gender: M   F      School Grade:       School:

Street:   City, State, Zip:  Phone:
Dad's Phone:     Employer:   Occupation:
Mom's Phone:   Employer:   Occupation:

Emergency Name:   Phone #:
Family Doctor:        Phone #:

 Class:     Register Date:       Register #:  
 Paid For?        Notes:      Email:
T-Shirt Size: Children's Medium (10-12) Children's Large (14-16) Adult Medium