Team Preference
Registration Information
First Name: *
Last Name: *
Cell:
Email Address: *
Jersey Size: *
Emergency Contact Information
Emergency Contact: *
Emergency Phone: *
Fundraising Commitment
Account Information
Custom URL:* Create your custom url to use for your personal fundraising page (This will also be your account username)
https://www.rayze.it/clubhouse/
Personal Image:
Personal Message:
Additional Information optional
Additional Comments:

Only enter this field if you were told to do so by a staff member.


The Clubhouse is a non-profit 501c3 organization.
Tax ID# 47-2966355
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