MBC Table Tennis Camp 2024 Registration
9:00 am-Noon, June 24-28 | Please fill out this form and click submit to register for MBC Table Tennis Camp 2024.
Camper's Name
*
Camper's Address
*
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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
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PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Email
*
This address will receive a confirmation email
Gender
*
Please select all that apply.
Male
Female
Date of Birth
*
Allergies/Important Medical Conditions
School Grade as of 9/24
*
How did you find out about MBC Table Tennis Camp?
Parent/Guardian
*
Relationship to Camper
*
Home Phone
*
Daytime Phone
*
Cell Phone
*
Mailing 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
Email
*
This address will receive a confirmation email
T-Shirt Size
*
Please select one option.
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Select Option
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Video Promotion
*
Please select all that apply.
I also give permission to use photos/or video of my child in MBC Promotional materials.
Questions or Comments
Payment
$75.00
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
9:00 am-Noon, June 24-28
Please fill out this form and click submit to register for MBC Table Tennis Camp 2024.
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