Individual Registration

Fields marked with an * are required.

Parent/Guardian Information

Parent/Guardian Name:

Address:

City:

State:

Email Address:

Daytime Phone Number:

Child Information

Child 1 Name:

Age:

School:

Child 2 Name:

Age:

School:

Child 3 Name:

Age:

School:

Child 4 Name:

Age:

School:

Waiver Information

I agree to have my picture, and any picture of my child or family members associated with the National Women and Girls in Sport Day, posted in any and all Loyola Athletics media outlets, including websites, mailings, newsletters, slide shows etc.

To confirm

Check here