Cteen Jr. Event Registration

Address

Parents information:
Mother's Name*
First Name Last Name
Mother's Mobile*
Mother's E-mail*
Marital Status
Father's Name
First Name Last Name
Father's Mobile
Father's E-mail
Cteen Jr. Member: 6th-8th Grade:

Membership ($50) includes:

6 events/trips.
I would like to:*

Become a Cteen Jr. Member - $50Pay for each event individually
If you choose the paid membership option. Do not click off each event individually as it will charge you again. You can write in the comments section which events you do not plan on attending.

If you are a Cteen Jr. member you do not need to sign up for each individual event.
I plan on attending the following Cteen Jr. events (All events are included in the membership)

Sunday, October 25Sunday, November 22Sunday, January 24Sunday, February 7Sunday, March 14Sunday, May 16
I plan on attending the following cteen events

Sunday, October 25Sunday, November 22Sunday, January 24Sunday, February 7Sunday, March 14Sunday, May 16
Total

$0.00
Commentts:
Commentts: (If you chose the paid membership option and you do not plan on attending an event, please make note of it here).

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

This page uses TLS encryption to keep your data secure.

CTeen Jr. (6th - 8th grade)