JPII HS Social Club Student Registration For 2007-2008

Enter your first name Enter your last name Enter your evening contact phone Enter your street address Enter your city/state/zipcode, like Royse City, TX 75189 Enter your email contact for Social Club Information

Enter your gender Female Male

Enter your age 13 14 15 16 17 18 19

Enter your grade 09th Grade 10th Grade 11th Grade 12th Grade

Were you a 2006-2007 Social Club Member? Yes No

Check all the Social Club activities you wish to join I want to participate in basic ballroom dancing I want to try out for the dance team I am not interested in ballroom I want to participate in basic rockclimbing and rappelling I want to try out for climb team(Climb Camp Oct 19-21 Required I am not interested in rockclimbing and rappelling I am interested in future trips I am not interested in trips

Indicate your dance experience This means any type of dancing, like ballet, jazz, tap, ballroom No dance experience Limited dance experience Multi-year dance experience

Indicate your rock climbing/rappelling experience No climbing experience Limited climbing experience Multi-year climbing experience