2023-24 OPCRC Gem's Registration
Kick Off Night: September 27; 6:30-8:30 p.m.
Parent Information:
Parents' Names
*
Primary E-mail
*
This address will receive a confirmation email
Secondary E-mail
Cell Phone
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Gems Information:
Gems' Name:
*
Grade:
*
Please select one option.
2nd
3rd
4th
5th
6th
7th
8th
Select Option
2nd
3rd
4th
5th
6th
7th
8th
T-shirt size:
Please select one option.
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Select Option
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Gems' Name
Grade:
Please select one option.
2nd
3rd
4th
5th
6th
7th
8th
Select Option
2nd
3rd
4th
5th
6th
7th
8th
T-shirt size:
Please select one option.
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Select Option
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Gems' Name:
Grade:
Please select one option.
2nd
3rd
4th
5th
6th
7th
8th
Select Option
2nd
3rd
4th
5th
6th
7th
8th
T-shirt size:
Please select one option.
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Select Option
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Health info: (Alleriges, etc.)
Emergency Contact Info:
If parent not available, please contact: (Name, cell phone)
*
Photo Release Permission
I give permission for OPCRC GEMS to take pictures of my daughter(s) at GEMS sponsored events for the purpose of posting pictures on OPCRC affiliated social media pages, website and for use during OPCRC worship services.
*
Please select all that apply.
I agree
I do not agree
Club Dues
Club Dues
1 Gems' Girl ($25)
2 or more Gems' Girls ($50)
Other donation
If you are unable to pay, OPCRC will cover the cost of your Gems' girl(s) ($0)
1 Gems' Girl ($25)
2 or more Gems' Girls ($50)
Other donation
If you are unable to pay, OPCRC will cover the cost of your Gems' girl(s) ($0)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Kick Off Night: September 27; 6:30-8:30 p.m.
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