PAL Program Registration
Child Full Name
*
First Name
Last Name
Parent Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Phone Number
*
-
Area Code
Phone Number
Parent E-mail
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
PAL Sessions
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Open Play (Basketball)
Free
$
Free
Golf
$60.00
$
60.00
Dates and Time: TBA 10 weeks session
Boxing
$150.00
$
150.00
Tuesday and Thursday from 6:00pm to 8:00pm Ages 10 - 19 years PAL Boxing Ages 20 years and up must be registered with USA Boxing and have a current Boxing passbook.
Total
$0.00
$
0.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
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December
Expiration Month
Expiration Year
2026
2027
2028
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2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
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