Athlete Registration

Club Affiliation(Required)

Parent Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent Phone(Required)

Parent Email(Required)

Athlete Name(Required)

First Last

Athlete Birthday(Required)

Athlete Stunt Age (age as of June 1, 2024)(Required)

Upload Birth Certificate(Required)

Max. file size: 64 MB.

Athlete Medical Conditions

Emergency Contact(Required)

First Last

Emergency Contact Phone(Required)

Relationship to Athlete(Required)

Athlete Registration

Price:

Signature

Credit Card

Cardholder Name

Card Details

Total

227152468