ROH REGISTRATION FORM
Comprehensive Sports/Mentoring Program Registration Form
Child's Name
First Name
Last Name
Age
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Cell Number
Please enter a valid phone number.
School
Parent/Guardian Name
First Name
Last Name
Email
example@example.com
Emergency Contact
Phone Number
Please enter a valid phone number.
Youth Shirts
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Shirts
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Program Selection
Boxing
Double Dutch
Media
Is your child on medication or has special needs?
Type Name of Parent or Guardian
Signature
Clear
Submit
Should be Empty:
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