Shooting Stars
Gender
*
Male
Female
Sport
*
Basketball
Cheerleading
First Name
*
Last Name
*
Address
*
City
*
State
*
Zip Code
*
Phone Number
*
Emergency Phone
*
Wheelchair
*
No
Yes
Walker
*
No
Yes
Diagnosis
Special Needs or Requirements
Allergies or Diet Restrictions
Buddy Preference
*
Adult
Young Adult
Parent
Sibling
Any
Buddy Gender
*
Any
Male
Female
Shirt Size
*
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Small
Medium
Large
XL
2XL
3XL
I have read the waiver on the web site to give permission for my child to participate.
*
No
Yes
Signature
*
Your Email Address
*
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