Online Membership Renewal

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2010 / 2011 Season Online Renewal Form

Parental Info

Fathers Name

Fathers Information

First Name * Last Name *

Address

Street * City * State * Zip *

Phone & Email

Home Phone * Cell Phone Email * Email #2

Mothers Name

Mothers Information

First Name Last Name

Number of Daugters Joining 1 2 3

Daughters Information

First Daughter Information

Daughters Name

First Name * Last Name * Tribe * Indian Name *

Second Daughter Information

Daughters Name

First Name Last Name Tribe Indian Name

Third Daughter Information

Daughters Name

Daughters Info

First Name Last Name Tribe Indian Name

Tribe Preferences

I agree to allow any photographs taken of myself and/or daughter(s) to be reproduced for publication whether electronic, print, digital or publishing via the Internet for the use of promoting the Pathfinder organization. Yes No

Renewal Fees: $25 per Dad / Daughter Team $10 per Additional Daughter

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