CPA Registration Form

CPA Registration Form

Application for Admissions
Student Name *

First Name Last Name
E-mail *
Age *
Date of Birth *

Month Day Year
Date Date Picker Icon
Weight *
Height *
Phone Number *

Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

How did you hear about Champion Prep Academy? *
Please mark which sport you are interested in: *

Baseball Basketball Football
Present Grade *
Current school and GPA: *
Guardian Information

Please enter parent or legal guardian information below:
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email
example@example.com

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Position Offense

QB RB WR OL
Position Defense

DB DL LB
Special Teams

K P LS
Applicant paste a link to your highlight film
All application fees are non refundable. *

Please check box if you agree with these terms.
Registration: *

Registration Fee $ 50.00

Total $ 0.00
Should be Empty:

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