Minis Registration Form

Hello! Welcome to the Mini Mustangs Registration! Please fill out the form below and Etransfer $20 to Treasurer@chilliwacklacrosse.com to secure your registration. Please include players name in the comment section of the Etransfer. Thank you and see you soon!
Player Name*

First NameLast Name
Players Date of Birth*

MonthDayYear
Date
Parents Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail*
example@example.com
Phone Number*
Please enter a valid phone number.
Please review the insurance waiver here: Insurance Waiver
I have read and agree to the terms of the insurance waiver
Comments
Should be Empty: