CHRISTeens Registration 2016
Student First Name
*
Student Last Name
*
Student Email
Student Telephone
Parent First Name
*
Parent Last Name
*
Parent Telephone
*
Street Address
City
State
Zip
Select T-Shirt Size
*
Small Adult
Medium Adult
Large Adult
X-Large Adult
2X-Large Adult
Our preferred payment method is Online; however, the option for cash/check is also available. Please select your payment method and complete registration.
Select Method of Payment:
*
Pay Online (Add $42) (Add $42.00)
Pay $42 by Check/Cash
Yes - I want a T-Shirt - Must order by Feb 7th
*
Pay Online (Add $16) (Add $16.00)
Pay $16 by Check/Cash
No Shirt
Your Email Address
*
Total
$
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