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MEMBERSHIP REGISTRATION FORM:
After completion of this form, please select "SUBMIT" and you will be directed to the online/mail in payment page.
MEMBER INFORMATION
*
Indicates required field
Name
*
First
Last
Last
Spouse's Name
*
First
Last
Home Phone
*
Cell Phone
*
ALUMNI
*
YES
NO
Address
*
Zip Code
*
Contact Email
*
Alternate Email
*
Membership Type (Note-Ads must be submitted by 7/22 to be in All Sports Program!)
*
Churchill $1000 - All Sports Program Full Page Ad
Winston $500 - All Sports Program 1/2 Page Ad
Charger $200 - All Sports Program 1/4 Page Ad
Black $100 - Website Recognition, WC CSA Decal
Red $25 - Website Recognition
Payment Method
*
Online
Mail in
STUDENT 1 INFORMATION
Special Note-
ALUMNI WITHOUT A CURRENT CHURCHILL ATHLETE DO NOT HAVE TO FILL OUT THE STUDENT INFORMATION
Than
k you!
Name
*
First
Last
M/F
*
Female
Male
Grade Level
*
9th
10th
11th
12th
Sport(s)
*
Baseball
Basketball
Cross Country
Football
Golf
Soccer
Softball
Special Olympics
Swim & Dive
Tennis
Track & Field
Volleyball
Water Polo
Wrestling
STUDENT 2 INFORMATION
Name
*
First
Last
M/F
*
Female
Male
Grade Level
*
9th
10th
11th
12th
Sport(s)
*
Baseball
Basketball
Cross Country
Football
Golf
Soccer
Softball
Special Olympics
Swim & Dive
Tennis
Track
Volleyball
Water Polo
Wrestling
STUDENT 3 INFORMATION
Name
*
First
Last
M/F
*
Female
Male
Grade Level
*
9th
10th
11th
12th
Sport(s)
*
Baseball
Basketball
Cross Country
Football
Golf
Soccer
Softball
Special Olympics
Swim & Dive
Tennis
Track & Field
Volleyball
Water Polo
Wrestling
Additional Comments
*
Submit
Home
About
>
CSA Officers & Executive Board
CSA Sports Reps
CSA Calendar
Contact Us
Sports
>
WC Camps
Athletic Trainer Information
Baseball
Basketball - Boys
Basketball - Girls
Cross Country
Football
Golf
Soccer - Boys
Soccer - Girls
Softball
Swim & Dive
Tennis
Track & Field - Boys
Track & Field - Girls
Volleyball
Water Polo
Wrestling
Membership
All Sports Program
Events
Meet the Chargers
Charger Golf Classic
Program Sponsors
Hall of Honor
Hall of Honor Recipients