CART Youth Student Registration

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Student Name (last name, first name):

       

Phone (nnn-nnn-nnnn):

Address:

City:

, WA

ZIP:

Emergency Contact:

 

Emergency Phone (nnn-nnn-nnnn):

E-Mail:

Insurance Carrier:

Student Age:

Student Sex:

Your CURRENT Skiing or Boarding Ability:

Any additional information you think we should know about you: