Parent Information

Parent / Guardian First Name*

Parent / Guardian Last Name*

Parent / Guardian Email Address*

Parent / Guardian Phone Number*

Address Line 1*

Address Line 2

City*

State or Province*

Zip or Postal Code*

Child Information

Number of Children Registering *

Child #1 Full Name*

Child #1 Birthdate*

Child #2 Full Name

Child #2 Birthdate*

Child #3 Full Name

Child #3 Birthdate*

Child #4 Full Name

Child #4 Birthdate*

Child #5 Full Name

Child #5 Birthdate*

What Eastern Michigan Sports is your child interested in?

Football

Baseball

Women's Basketball

Golf

Gymnastics

Lacrosse

Rowing

Soccer

Swimming & Diving

Tennis

Track & Field / Cross Country

Volleyball