Page 1 of 1

Code Arizona Registration

Participant First Name

*

Participant Last Name

*

Participant Email

*

Participant Age

*

Participant School

*

Participant Adult TShirt Size

*

Participant Adult TShirt Size

A

S

B

M

C

L

D

XL

Guardian First Name

*

Guardian Last Name

*

Guardian Phone Number

*

Guardian Email

*

By signing below, I confirm that I have read and understand the Code Arizona Media & Liability Release, and I agree to its terms.

*

Signature