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if checked, please complete the entire form

Name *

First Name

Last Name

Birthday *

MM

DD

YYYY

Phone number *

(###)

###

####

Emergency phone *

(###)

###

####

Shirt size *

Small

Medium

Large

X Large

2X Large

Swimming ability: *

Strong

Moderate

Weak

Gun safety course *

My YW is allowed to participate in a Gun Safety course and shoot on appropriate ranges with knowledgable supervision.

Gun

Archery

None

Parent/guardian electronic signature and date *

TO BE COMPLETED BY A PARENT OR GUARDIAN: I have reviewed and approve the completed "Permission and Medical Release Form" along with this registration form.

Yes

Date *

MM

DD

YYYY