REGISTER YOUR ATHLETE

Participant Name *

First Name

Last Name

Address

Athlete's Primary Residence

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Birth Date *

MM

DD

YYYY

Gender *

Male

Female

Parent/Guardian Name *

Primary Guardian

First Name

Last Name

Phone

(###)

###

####

Parent/Guardian Name

Parent 2

First Name

Last Name

Phone

(###)

###

####

Secondary Address

if different than athlete's address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

emergency Contact Phone *

(###)

###

####

I need to make payment with cash/check

*only choose this option if you can NOT pay with a credit/debit card **By selecting this option, you agree to mail cash/check to LYFC at PO Box 1060 Linden 95236 upon completion of registration.

Paying Cash

Paying Check