MINI COMETS REGISTRATION FORM - WINTER 2012

Childs First Name:
Childs Last Name:
Sex:
Date of Birth:
Grade:
School:
I'd like to play on a team with the following players:
Address:
City:
State:
Zipcode:
Home Phone:
Email:
Mom’s Name:
Mom’s Cell:
Dad’s Name:
Dad’s Cell:

T-Shirt Size: