6/8-6/13 Jacksonville Florida

First and Last Name (姓名） *

Mobile Phone（手機）xxx-xxx-xxxx *

Email address （電子信箱） *

Gender (性別） *

Grade completed by June 2026 學年 *

T-shirt size (Adult Size) *

Date of the Tetanus shot *

Parent's name (For age 18 and under, others type "A") *

Parent's mobile phone (For age 18 and under, others type "A") *

$314 per person. Two ways to pay *

By Check: mail your check to 2110 Corporate Square Blvd, Jax, FL 32216. Title: CCCJ; Memo: WC for Youth name

Zelle: transfer the money to cccjfl@gmail.com

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