Parent / GuardianParent/Guardian Name* First Last Parent/Guardian Email* Cell Phone* AthleteAthlete's Name* First Last Athlete's BirthdayPlease enter year of athlete's birth. MM DD YYYY Athlete's Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Age at Program Time*Grade in Fall*School in Fall*Athlete's Email Athlete's Cell Phone Parents InformationFather's Name First Last Cell PhoneWork PhoneEmail Mother's Name First Last Cell PhoneWork PhoneEmail Athlete lives with: Both parents Mother Father Other Please explain Additional emergency contacts, when I cannot be reached: In addition to those already listed above, two more contacts are required by the State of Colorado Department of Childcare. The following have my permission to sign my child out from the program and may be contacted in an emergency in case I cannot be reached. Emergency Contact #1 First Last Relationship*Cell Phone* Program Fee Program Cost $425.00Credit Card / PayPal Price: $425.00 Program Total $0.00 What does 3 + two = ?*Our SPAM blocker!Please enter a value between 5 and 5.