Youth Archery Registration Form 

Date of Birth: _________________   Age: _______  Previous Archery Experience Y  /  N

Requires use of club equipment:   Y  /  N

Allergies/Medical concerns: ______________________________________________________

________________________________________________________________________________

GUAN-HO-HA YOUTH ARCHERY PROGRAM
Registration Form

I give my child _________________________________________________
permission to participate in the Guan-Ho-Ha Youth Archery Program.

Parent/Guardian Signature: _______________________________________

                         Printed Name: ______________________________________

Child Information:

Last Name: _____________________________________________________________________

First Name: _____________________________________________________________________

Contact Information:

Home Address: ________________________________________

                 _____________________________________________

                 _____________________________________________

Home Telephone: _____________________    Cellular: ______________________

E-Mail Address: ______________________________________________________

Emergency Contact #1                                      Emergency Contact #2

Name: ______________________                               Name: _____________________

Relationship: _______________                               Relationship: ________________

Telephone: _________________                               Telephone: __________________