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Registration
Please have your parents read & sign the forms below:
Rules
Parents release form
2010 MACYAC Registration
First Name *
Last Name *
E-mail address *
Phone Number *
555-555-5555
Address *
City *
State *
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code *
Birthday (mm/dd/yyyy) *
Example: 01/01/1990
Grade Level (Fall 2010) *
Freshman - HS
Sophomore - HS
Junior - HS
Senior - HS
College
Chaperone
Emergency Contact *
Emergency Phone Number *
555-555-5555
Church *
St. Mary - Greenville, SC
St. Mary - Raleigh, NC
St. Mark - Charlotte, NC
St. Mark - Myrtle Beach, SC
Other
Other Church
Roommate Preference 1
Roommate Preference 2
Roommate Preference 3
Shirt Size *
X-Small
Small
Medium
Large
X-Large
Will you be a deacon? (Guys Only)
Yes
No
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