.

Child Information (Adults with no children may register by filling out the Parent Information Section only)

First Name

Last Name

Parent / Guardian Information / Adult (18 years and older)

First Name

Last Name

Parent / Guardian Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone

(###)

###

####

Media Permission

Please indicate if you authorize your child to be photographed and those photos be posted on our SBC website or newsletter

Yes

No