Registration
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Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Questions/Options:
Is this donation sponsoring one of our athletes? If so who?
How much would you like to Donate to the KY National Guard Soldiers?
Do you want us to run your card or would you like to bring in cash?
Additional Information:
Other Questions/Comments:
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