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Registration Form created by
Chris Meier
Guest Email*
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Send me a confirmation email (recommended)
Childcare RSVP
-- select an option --
Yes
No
# of K5-Grade for Childcare
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1
2
3
4
5
6
7
8
9
10
name*
name*
Appetizer to serve 10
-- select an option --
Yes
No
Salad to serve 10
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Yes
No
Appetizer to serve 10
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Yes
No
Drinks
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Yes
No
Additional Guest Name
Athlete First Name*
Student Name*
Student Name*
Student Name*
Student Name*
Student Name*
Student*
Student Name*
Student Name*
Student*
Student*
Student Name*
Student Name*
Student Name*
Student Name*
Student Name*
Student*
Student Name*
Student Name*
Student Name*
Student Last Name*
Student Last Name*
Student Last Name*
Student Last Name*
Student Last Name*
Guest Attending
Guest Attending
Athlete Last Name*
Guest email address*
Number of Guests Attending*
-- select an option --
1
2
3
4
5
6
7
8
9
10
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Grade*
Current Grade*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Teacher*
Date of Birth dd/mm/yy*
Contact me about a donation to the aucti
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Yes
No
Parent Name*
Parent Name*
Parent Name*
Parent Name*
Parent Name*
Teacher*
Parent Name*
Parent Name*
Parent Name*
Parent Name*
Teacher*
Parent Name*
Parent Name*
Parent Name*
Parent Name*
Parent Name*
Swimmer or Diver?*
Email Address*
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Email Address*
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Email Address*
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Email Address*
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Email Address*
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Email Address*
Please re-enter the Email Address*
Email Address*
Please re-enter the Email Address*
Email Address*
Please re-enter the Email Address*
Email Address*
Please re-enter the Email Address*
Email Address*
Please re-enter the Email Address*
Email Address*
Please re-enter the Email Address*
Email Address*
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Email Address*
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Email Address*
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Email Address*
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Email Address*
Please re-enter the Email Address*
Address: Street, City, Zip*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Home Phone*
Athlete Cell Phone #
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Cell Phone*
Athlete email
Please re-enter the Athlete email
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone*
Business Phone*
Business Phone*
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Business Phone
Parents Names*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Alternate Emergency Contact*
Parent Cell Phone Number #1*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Alternate Emergency Contact Phone*
Parent Cell Phone Number #2
I have reviewed the ASE Program, Policie*
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Yes
No
I have reviewed the ASE Program, Policie*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
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Yes
No
I reviewed the ASE Policies & Procedures*
-- select an option --
Yes
No
Medical Concerns/Allergies(List)
Medical Concerns/Allergies(List)
Medical Concerns/Allergies(List)
I reviewed the ASE Policies & Procedures*
-- select an option --
Yes
No
I reviewed the ASE Policies & Procedures*
-- select an option --
Yes
No
Parent email*
Please re-enter the Parent email*
I am a RES PTA member*
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Yes
No
I am a RES PTA Member*
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Yes
No
I am a RES PTA Member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
-- select an option --
Yes
No
I am a RES PTA member*
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Yes
No
I am a RES PTA member*
-- select an option --
Yes
No
I am a RES PTA member*
-- select an option --
Yes
No
I am a RES PTA member*
-- select an option --
Yes
No
Any food allergies? Specify what food.
Any Medical Concerns/Allergies? (Please
Any Medical Concerns/Allergies? (Please
I am a RES PTA member*
-- select an option --
Yes
No
Medical Concerns/Allergies(List)
Medical Concerns/Allergies(List)
Medical Concerns/Allergies(List)
Swim suit size
Medical Concerns/Allergies(List)
Athlete t-shirt size
-- select an option --
Small
Medium
Large
X-Large
XX-Large
Preferred Sub: Ham, Turkey or Italian
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Registration Form created by Chris Meier
Registration Form created by Chris Meier
