Stronghold Program Registration

Parent/Guardian First Name: Parent/Guardian Last Name: Email: Cell Phone: (Please opt in for text messaging below so we can inform you about event details like weather cancellations) Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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 American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Emergency Contact Name Emergency Contact Phone Number Names of all those allowed to pick the child up from the event Number of Children Attending: Would you like to hear about upcoming events with Stronghold Foam Sword Fighting's Newsletter? Yes, please No, thank you I am already subscribed to the newsletter If you have a coupon, please enter code here (case-sensitive): Relation of Registrant to Attendees:   Same Household Same Company