MINI AND PEE WEE PREDS ONLINE REGISTRATION
April 11, 2012 and running for 9 weeks
(All Fields Must Be Filled In)
Last Name
First Name
Street
City
Postal Code
Gender
Male
Female
Home Phone Number (xxx-xxx-xxxx)
E-mail Address
Year Of Birth
2007
2006
2005
2004
2003
2002
Month of Birth
January
February
March
April
May
June
July
August
September
October
November
December
Day of Birth
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Parents' Name(s)
Parents' Contact Phone Number
Emergency Contact
Emergency Contact Phone Number
T-Shirt Size
Youth XS
Youth Small
Youth Medium
Youth Large
Youth X-Large
Small
Medium
Large
X-Large