TeamPages: Wolfpack Demo - Winter 2017 Registration

Winter 2017 Registration

hideYou should not enter any sensitive information on this page such as health data, passwords, credit cards or social security numbers. If you are being asked or need to provide this information for your registration please contact Wolfpack Demo directly. A secure checkout page will be used to collect your payment details on the next page.

Pricing Details

Division Registering for:
None Selected	-
U10	$ 100.00
U12	$ 110.00
U14	$ 120.00
U16	$ 130.00
U18	$ 140.00

$ 0.00 Total:

Winter 2017 Registration

Welcome to the Pumas registration page

*Player Name:

Name:

*Birth Date:

Birth Certificate (please upload an image of your child’s birth certificate

*Address:

Street Address:
City: State/Province: Country: Zip/Postal Code:

Proof of Residency (please upload an image of your proof of residency)

*Parent/Guardian #1 Name:

Name:

*Parent/Guardian #1 Cell Phone Number:

*Parent/Guardian #1 Email Address:

Medical Information

Doctor

Name:

Phone Number:

Please list any allergies or medical conditions we should be aware of:

Medical Waiver

Please Click Here to read medical waiver

I have read and agree to all terms and conditions above

or cancel

Wolfpack Demo

Winter 2017 Registration

Pricing Details

$ 0.00 Total:

Winter 2017 Registration

Medical Information

Medical Waiver

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