THSM HoopDeeDoo 2013 Registration

Student Information:

First Name Last Name Cell Phone #

__________________________________ __________________________________ __________________________________

Age Grade Gender Email If Visitor, Friend of:

_________ _________ _______ ___________________________________ ___________________________

Parent Information:

Parent Name Contact Phone # Parent Email

__________________________________ ___________________________ _________________________________________

Payment: _____Cash _____Check (#_________) _____Online

THSM HoopDeeDoo 2013 Registration

Student Information:

First Name Last Name Cell Phone #

__________________________________ __________________________________ __________________________________

Age Grade Gender Email If Visitor, Friend of:

_________ _________ _______ ___________________________________ ___________________________

Parent Information:

Parent Name Contact Phone # Parent Email

__________________________________ ___________________________ _________________________________________

Payment: _____Cash _____Check (#_________) _____Online