Cteen Jr Club

"*" indicates required fields

Cteen Jr's Name:*

Grade:*

Cteen JR #2 (If sibling, if not related please fill out a separate form.)

Grade:

Cteen JR #3 (If sibling, if not related please fill out a separate form.)

Grade:

Father's name*

Father's cell*

Father's email*

Mother's name*

Mother's cell*

Mother's email*

Address:*

Cteen JR Event Charge *

Price: $10.00

Sponsorship Opportunities

Co-sponsor $180

Sponsor $360

Total

Credit Card*

American Express

Discover

MasterCard

Visa