Name*:  
Team Name (if coming in a group)

Address 1*:  
Address 2:
Address 3:
Town/City*:  
State*:   Please select a state... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip*:
Email*:
Date of Birth*:   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 /
Home Phone (XXX-XXX-XXXX)*:  
Cell Phone (XXX-XXX-XXXX)*:  
Do you consider yourself medically fit*: 
Yes   No  

Planning on participating in what (choose all that apply)*:
Night Games

Gaming will be offered to a limited amount of participants, and will be available strictly on a first come first served basis.  Payment is required for you to secure your place in the games. 

If participant is between the minimum age of 12 years old and 18 years old, parental approval is required.  Parents must fill out a Liability Waiver in order to be allowed to participate (no exceptions period).  If you are between the age of 12 and 18 years old you should fill out the form on-line. Payment online will help insure your placement.  You still will be required to send in or bring with you the parental consent on your completed liability waiver.  Printable registration is available here.