L.I.F.E. Back 2 School Registration

L.I.F.E. Back 2 School Registration
REGISTRATION MUST BE COMPLETED BY AUGUST 7, 2012!

* Indicates required field

Parent's name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Child's name *

First

Last

School name & address *

DOUBLE DUTCH TEAM

All teams must have three members to compete and everyone in the team must be present to qualify. More information will be given the day of the event. Please wear safe/comfortable clothing and shoes.

Are you interested in competing in the Double Dutch Contest? *

Yes No

Please list two other members of your team: *

Submit

L.I.F.E. Back 2 School RegistrationREGISTRATION MUST BE COMPLETED BY AUGUST 7, 2012!

DOUBLE DUTCH TEAM

L.I.F.E. Back 2 School Registration
REGISTRATION MUST BE COMPLETED BY AUGUST 7, 2012!