Welcome to Mater Dei High School

Mater Dei Alumni Soccerfest 2008
November 28, 2007 at 12:00 p.m.

*Required

* registrations at $10 each.

Names of registrants:

1	5
2	6
3	7
4	8

Adult Shirt Sizes:

Small

Medium

Large

X Large

XX Large

*Name:

*Address:

*City:

*State:

*Zip Code:

*E-Mail:

*Date of Birth:

*Graduating Year:

*Emergency Contact:

*Emergency Phone:

Credit Card Information

Credit Card #		Expiration Date / mm/yy
CVV2 (3 digit number on back of card) This information is gathered by authorize.net and not stored by Mater Dei HS.

Comments:

I hereby release, absolve, and hold harmless, Mater Dei High School, St. Mary Parish, the Mater Dei High School Alumni Association Corporation, the organizers, officers, managers, trustees, coaches and supervisors from any liabilities which may arise. By checking the box below, you will have accepted the previously stated terms.

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