Athlete

Name:____________________________________
 
Address:_________________________________________________________

City, State, & Zip:____________________________

Phone:____________________      E-mail:______________________________

Parents

Father:_____________________     Mother:_________________________

Address:_________________________________________________________
(If different from above)

City, State, & Zip:____________________________

Phone:____________________      E-mail:______________________________

Athletes Information

Grade:________   DOB:____________

Ht:______   Wt:______       Position:____________________

Jersey size ___________ Shorts size__________    

You will also need a photocopy of your school ID card showing you are in good standing.
Dues   Returning Player     New Player
               $35 Cipp Fee             $35 Cipp Fee                 
                $30 Club Dues          $30 Club Dues
                                                     $20 Club Kit Bag (Must Have)