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Registration Form
Sponsors

This is a generic registration form for The FLARE!.
You may submit your form electronically but we also recommend that you print it out and send it in. If you are under 18, this form MUST be signed at the bottom by a parent or legal guardian. YOUR REGISTRATION IS NOT FINAL UNTIL YOU HAVE HAD YOUR LEGAL GUARDIAN SIGN THIS AND PAID YOUR FEE.

Full Name:
Street Address:
City, State Zip:
Birthdate:
Email:
Parent Names:
Parental Numbers:
Secondary Contact:
Secondary Numbers:
Insurance Company:
Ins. Phone Number:
Policy Number:
Allergies:
Medications:
Additional Info:
Spam Check: Please enter 777 here:
Permission Signature of Parent/Guardian:

___________________________________________________



You must also download, print and have your parent's sign the Liability Release Form.