Fields marked with * are mandatory
General

First Name *
*Please enter valid First Name
Last Name *
*Please enter valid Last Name
Preferred Name
*Please enter valid Preferred Name
Date of Birth *
*Please enter valid Date of Birth
Email Address *
*Please enter valid Email Address
Player Cell Phone Number *
*Please enter valid Player Cell Phone Number
Address1 *
*Please enter valid Address1
Address2
*Please enter valid Address2
City *
*Please enter valid City
State *
*Please enter valid State
Zip *
*Please enter valid Zip
Country *
*Please enter valid Country
Emergency Contact Name *
*Please enter valid Emergency Contact Name
Emergency Contact Phone *
*Please enter valid Emergency Contact Phone
Emergency Contact Email *
*Please enter valid Emergency Contact Email
High School *
*Please enter valid High School
Club Team
*Please enter valid Club Team
T-Shirt Size (Unisex) *
*Please enter valid T-Shirt Size (Unisex)
2017 Camp Attending
*Please enter valid 2017 Camp Attending