Instructions for a parent or guardian
Please print this form out, complete it and fax it to the number specified (if present) or mail to the mailing address below.
404 Cambria Ct
Cranberry Township, PA 16066
|Choose a Member Name
Member names must be between 3 and 32 characters long.
|Choose a Password
Passwords must be between 3 and 32 characters long.
|Your email address
You will need to enter a real email address.
Please sign the form below and send to us.
I understand that the information that the child has supplied is correct. I understand that the profile information may be changed by entering a password and I understand that I may ask for this registration profile to be removed.
|Parent / Legal Guardian FULL name|
|Relation to child|