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Student Registration

Last Name    First Name 

Email Address 

    Gender   

Grade  School

Birthday   

Address 

City   State  Zip

Home Phone (Area Code)  -

Emergency Contact: Name   

                                     Phone

Event

T Shirt Size

Participant Status

Visitors, I'm a guest of

Comments

Please send in a completed, signed Medical Release/Permission Form to participate in GVBC Student Events.