Player
name (please print): _____________________________________________________
Boy
__ Girl __ Age
____ Birth
date: Mo. ____ Day____ Yr.____
Parent/Guardian
____________________________
Telephone
# _____________
Cell phone # _______________
If
your child attends church, name of church
________________________________________
Early registration deadline: March 14th, 2008
Add $2.00 extra for each registration received after March 14th.Parents, would you be willing to: _____ be a coach _____ be an assistant coach
#1. Please make all checks payable to: Pleasant View Bible ChurchParent or Guardian Accepts All Responsibility for Injuries or Accidents.
#2. Staple your check to the registration form(s)
#3. Parent or guardian, sign below.
#4. Return form to: Belinda Rider
940 E. River Ave.
Warsaw, IN 46582