Student Name ______________________________________________________________________
Address __________________________________________________________________________
City
________________________________
State
________________ Zip ________________
Home Phone
_______________________________________________________________________
Name of Emergency
Contact
___________________________________________________________
Grade (2007-2008 School Year)
__________ Birth Date _________________ Gender __________
Parent/Guardian
Name ________________________________________________________________
Signature
__________________________________________________________________________
Shirt Size
(Circle one)
Youth: S M L Adult:
S M L XL
INDIVIDUAL
RATE: $90
(T-shirt included)
Family
discounts available
Non-refundable
deposit of $30 required with application
Balance
due one week prior to attending
Please make checks payable to
Nashua Catholic