Registration Form
College Park Boys and Girls Club 2010

Please Fill Out the form, Print and Bring it in the registration date

Child 1st Name Last Name
Birth Year Month /Day Sex M F
Address City Zip Code E-mail
School
Parent 1 Phone Cell # Work Phone
Parent 2 Phone

Check ("x") Sports for this Registration Only

Sport
Cost
Sport
Cost
BBSL spring Soccer
$125
   BBSL Fall Soccer
$125
Takoma Park Soccer Spring
$50
   Takoma Park Soccer Fall
$50
PGSL Spring Soccer
$70
   PGSL Fall Soccer
$70
MSI Spring Soccer
$125
   MSI Fall Soccer
$125
Soccer Spring Clinic
$50
   Soccer Fall Clinic
$50
Softball
$50
   T-Ball
$50
Baseball Spring
$50
   Baseball Fall
$50
Cheerleading
$55
   Basketball
$50
Lacrosse
$90
    

For Club Use Only

County Fees $ ___20__________ Membership Card__________________
Adult Member Fee: _10________  
Equipment Fee ____________  
Sport Fee ________________  
Service Hr. Fee____________ Yellow Card: ______________________
Late Reg. Fee ________________  
Total Fees: _________________ Proof of I.D. ______________________
Less Credit: ______________  
Amount Due______________ Family Hrs 2006____________________
Amount Paid______________  
Balance Due______________ Check # ________________ or Cash ___________________

The College Park Boys and Girls Club is a 100% Volunteer Organization. Our Success is dependent upon the Support and to help. dedication of our parents and friends. Please check (x) those areas where you can help.

Coaching
Administration
General Activities
C-Baseball
Registration
Snackbar
C-T-Ball
Computer Help
Newsletter
C-Softball
Website
Groundskeeping
C-Football
Equipment
Social Events
C-Basketball
Phone Calling
 
C-Soccer
 
   
C-Cheerleading
 
   

My child, listed above, has my permission to join the CPBGC. I waive any claims against CPBGC or any of it's agents, in the event of an accident to my child. I agree that my family will volunteer a total of 10 service hrs per year or pay a fee of $5.00 per hour not worked. As an adult member, I agree to abide by the by-laws and policies of the CPBGC.

Adult Member Signature ___________________________________________ Date: _____________