Crossroads Mustang

Child's first name

Child's last name

Grade in the Fall

Shirt size

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Parent/Guardian First name

Parent/Guardian Last name

Emergency Contact number

Special needs/allergies/other concerns

Photo Release: Crossroads Mustang has my permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publication, online publication, presentations, websites and social media. I also understand that no royalty, fee, or other compensation shall become payable to be by reason of such use.

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