The event sponsored by the Athletic Program at Cleveland High School, Portland, Oregon, that the participant wishes to attend.

If the activity covers multiple days, include the first day of the event

This the participant's current grade. If the activity is taking place during the summer, include the grade the participant will be entering in the fall.

Enter the participant's current age.

Include ALL phone numbers a coach could use to reach you or another responsible adult.

Location or person this phone # belongs to (e.g., home, mother, neighbor, etc.

List the full name of the company that provides participant's medical insurance for hospitalizations.

(e.g., numbers listed on participant's medical card)

List anything that might possibly affect participant's performance while participating in this event.