To create an account and to guarantee correct residency status, provide complete contact information.

Please note, the primary contact should be an adult. All other family members can be added in the "add member" section below.
First Name: *  (Primary Contact)
Last Name: *  (Primary Contact)
Gender: *
Address: *
City: *
State: *
Zip: *
Phone: *  (ex: XXXXXXXXXX)
Health Notes:
Emergency Contact:
Emergency Phone:  (ex: XXXXXXXXXX)

Email: *
Password: *  
Verify Password: *  
Password Requirements: Between 8-16 characters, 1 alphabetic, 1 numeric, 1 special character (!@#^*-=), no spaces
Yes, I want to receive email updates on events and activities
Family Members: