"*" indicates required fields Step 1 of 2 50% Mite Development ProgramSelect a Session and Level*Must register for Spring and Summer Sessions separately. SPRING 2024 Mite Development Program K/1st Grade - $455 SPRING 2024 Mite Development Program 2nd/3rd Grade - $455 SUMMER 2024 Mite Development Program K/1st Grade - $250 SUMMER 2024 Mite Development Program 2nd/3rd Grade - $250 Athlete InformationChild's First Name* Child's Last Name* Child's Date of Birth* Month Day Year Child's Gender*- Select One -MaleFemaleChild's Primary Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Medical conditions or allergies? (If yes, please explain)*Player Position* 2023-24 Team* Jersey Size*- Select One -Junior XSJunior S/MJunior L/XLSenior SmallSenior MediumSenior LargeSenior XLParent InformationPrimary Parent First Name* Primary Parent Last Name* Primary Parent Email Address* Primary Parent Cell Phone Number*Secondary Parent First Name Secondary Parent Last Name Secondary Parent Email Address Secondary Parent Cell Phone NumberEmergency Contact InformationEmergency Contact First Name* Emergency Contact Last Name* Emergency Contact Cell Phone Number*WaiverClick here to read the waiver.Consent* I acknowledge that I have read and understand the waiver.*Full Name*This serves as an electronic signature. Total Credit Card*Card Details Cardholder Name Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code CommentsThis field is for validation purposes and should be left unchanged. Δ
