Member Registration - Dunk4Dreams

Register with us by filling out the form below.

Please ensure that all information provided is complete and accurate. Incomplete or inaccurate registrations will not be processed. Providing false information may result in your registration being denied or revoked

RM_Stats
First Name^*
Last Name^*
Date of Birth
Gender
Male

Female

Phone Number
Email^*
Password^*
Password must be at least 7 characters long.
Enter password again^*
Password must be at least 7 characters long.

Address^*

Address Line 1 ^*

Address Line 2

City ^*

State or Region ^*

Country ^*

Zip ^*

Phone^*
Race/Ethnicity^*
Are you signing up for an individual membership or a group membership?^*
Participant #1 Full Name
Participant #1 Date of Birth
Participant #1 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #2 Full Name
Participant #2 Date of Birth
Participant #2 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #3 Full Name
Participant #3 Date of Birth
Participant #3 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #4 Full Name
Participant #4 Date of Birth
Participant #4 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #5 Full Name
Participant #5 Date of Birth
Participant #5 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #6 Full Name
Participant #6 Date of Birth
Participant #6 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #7 Full Name
Participant #7 Date of Birth
Participant #7 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #8 Full Name
Participant #8 Date of Birth
Participant #8 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #9 Full Name
Participant #9 Date of Birth
Participant #9 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
Participant #10 Full Name
Participant #10 Date of Birth
Participant #10 Race/Ethnicity
Emergency Contact Phone
Minor
Parent /Guardian Full Name
Email/ For Minor, provided Parent(s), Guardian(s) email address
By checking this box, I agree to have my name and contact information added to the member directory.^*
Yes

By submitting this form, I agree to the terms and conditions of membership as outlined on the non-profit's website.^*
Yes