Player Information: Your Name Address City/State/Zip Birthdate Sex Home Phone School Attending Parent/Guardian Information: Alt. Phone Parent/Guardian Alt. Phone Parent/Guardian Preferred Email(s) Emergency Contact Information: Alternate Contact Phone Phone Preferred Doctor Phone Preferred Dentist I.D. # Insurance Carrier Winter Session I Every Friday at the Ash Centre Beginning Nov. 16 $12/child per week Winter Session II Christ Church at Georgetown Beginning February 15 $72.00 for 6 week session