Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Would you be willing to coach an event at MAX?

Selecting an event does not designate you the coach but lets us know you are willing. Final coach and teams list will be sent out after registration closes.

JH Girls Basketball

SH Girls Basketball

JH Boys Basketball

SH Boys Basketball

Girls Volleyball

Flag Football

Soccer

Sand Volleyball (need 3)

JH Dodgeball

SH Dodgeball (need 2)

Spikeball

Allergies*

Please specify the severity of all allergies selected in the next section. (i.e. ingested tree nuts vs. contact with tree nut)

NONE

Vegetarian (will eat animal products, but not meat)

Vegan

Soy

Seafood

Shellfish

Gluten Intolerant

Peanut

Tree Nut

Eggs

Lactose Intolerant (dairy)

Other Food Allergies (specify below)

Other Medical Restrictions (specify below)