Utimate Frisbee Registration Form

Fall 2023

- Students have the option to participate in the Ultimate Frisbee Club or Club & Competitive.
- September 5th - October 29th (8 weeks)
- Grades 3-8
- All genders, identities, and abilities welcome
- Max of 20-25 students (minimum of 12 students to be offered)

For details, visit our website or email Peter Jensen at pjensen@lcmcs.org.
Student Information
Student's Name: Student's Name: First Last
Classroom
Age:
Birthdate: Birthdate: / MM / DD YYYY
Days that student will participate:

Days that student will participate: Club ($85) - Tuesdays from 3:45pm to 5:30pm Club & Competitive ($85 + additional $75 registration fee to be paid at a later date) - Tuesday practices & Sunday games
Parent Information
Parent's Name: Parent's Name: First Last
Parent's Email:
Cell Phone: Cell Phone: - ### - ### ####
Work Phone: Work Phone: - ### - ### ####
Other Phone: Other Phone: - ### - ### ####
Mailing Address Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Emergency Contact & Pickup Information
Emergency Contact: Emergency Contact: First Last
Emergency Contact Phone: Emergency Contact Phone: - ### - ### ####
Names of the individuals authorized to pickup student:
Payment Information
Checkboxes

Checkboxes I understand that the fee shown below is due upon registration. You will be directed to a payment page upon submission of this form.
$0

Total