Site Registration | Suffern Athletics: Online Forms

Registration

Username*
Password*
Enter Password Confirm Password
Name- Parent/Guardian*
First Last
Email- Parent/Guardian*
School*
How many children do you have in 6-12 grade?*
CHILD INFORMATION
Student Name*
First Last
Gender*
Student Email*
Age*
Date of Birth*
Month
Day
Year
Home Phone 1*
Student Cell Phone 1*
CHILD 2 INFORMATION
Student Name*
First Last
Gender*
Student Email*
Age*
Date of Birth*
Month
Day
Year
Home Phone 2*
Student Cell Phone 2*
CHILD 3 INFORMATION
Student Name*
First Last
Gender*
Student Email*
Age*
Date of Birth*
Month
Day
Year
Home Phone 3*
Student Cell Phone 3*
CHILD 4 INFORMATION
Student Name*
First Last
Gender*
Student Email*
Age*
Date of Birth*
Month
Day
Year
Home Phone 4*
Student Cell Phone 4*
CHILD 5 INFORMATION
Student Name*
First Last
Gender*
Student Email*
Age*
Date of Birth*
Month
Day
Year
Home Phone 5*
Student Cell Phone 5*
ADDRESS
Address*
Street Address City State ZIP Code
PARENT/GUARDIAN/EMERGENCY CONTACT INFORMATION
Parent-Guardian #1*
First Last
Parent Email*
Relationship*
Home Phone*
Cell Phone*
Work Phone
Parent-Guardian #2
First Last
Parent #2 Email
Relationship
Home Phone
Cell Phone
Work Phone
Emergency Contact
List relative or neighbor who will be available and permitted to pick up and/or assume temporary care if unreachable.
Alt. Contact #1*
First Last
Relationship*
Home Phone*
Cell Phone*
Work Phone
Address*
Street Address City State ZIP Code
Alt. Contact #2
First Last
Relationship
Home Phone
Cell Phone
Work Phone
Address
Street Address City State ZIP Code
PHYSICIAN/MEDICAL INFORMATION
Physician Name*
First Last
Phone*

Registration

CHILD INFORMATION

CHILD 2 INFORMATION

CHILD 3 INFORMATION

CHILD 4 INFORMATION

CHILD 5 INFORMATION

ADDRESS

PARENT/GUARDIAN/EMERGENCY CONTACT INFORMATION

Emergency Contact

PHYSICIAN/MEDICAL INFORMATION