Premier Youth Bowling Registration
Bowlium Lanes - 4666 Holt Blvd., Montclair, CA. 91763 - Saturdays at 11:00 AM
Today's Date
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/
Month
/
Day
Year
BOWLER'S NAME
*
First Name
Middle Initial
Last Name
AGE
*
BIRTHDATE
*
-
Month
-
Day
Year
Date Picker Icon
GENDER
*
MALE
FEMALE
USBC MEMBERSHIP #
(8/1 – 7/31) Current Year Fee is due at registration or on 1st day for new or expired memberships. (Cash only)
HAND USED FOR BOWLING
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RIGHT
LEFT
TWO HANDED (RIGHT)
TWO HANDED (LEFT)
BOWLING EXPERIENCE
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NEW BOWLER
UNDER 1 YEAR
1-3 YEARS
+3 YEARS
ARE THERE INJURIES OR PHYSICAL LIMITATIONS THAT MAY AFFECT THIS BOWLER'S ABILITY TO BOWL INDEPENDENTLY?
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YES
NO
If YES explain:
PARENT/GUARDIAN INFORMATION
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First Name
Last Name
PRIMARY PHONE #
*
Please enter a valid phone number.
ADDRESS; (PO BOX NOT ACCEPTED)
*
Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PRIMARY EMAIL
*
example@example.com
I authorize bowling photos of my son/daughter to be taken/posted on the league website and/or newsletter.
*
YES
NO
NAME OF BOWLER(S) YOU'D LIKE TO BE ON YOUR BOWLER'S TEAM:
TYPE ANY QUESTIONS OR COMMENTS FOR THE YOUTH PROGRAM DIRECTOR BELOW:
ALTERNATIVE PHONE # (RECOMMENDED)
Please enter a valid phone number.
ALTERNATIVE EMAIL (OPTIONAL)
example@example.com
PARENT/GUARDIAN SIGNATURE
*
Submit
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