CentriKid 2023 Registration Student's Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number*Email* Parent or Guardian* First Last Gender*MaleFemaleGrade Completed by Summer 2023*2nd3rd4th5thAge* Shirt Size* CentriKid Registration* $50 CentriKid Deposit Total $0.00 EmailThis field is for validation purposes and should be left unchanged. Δ
