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Super Kid Season Team Registration

Team Name

Your First Name

Email

Your Last Name

Team Captian

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Team Captains- please fill in the information below. Additional team members do not need to fill out this section.

Select Team Catagory

Corporate

Community

Youth

Individual

Returning Team

New Team

Team Fundraising Goal:

We would like to participate in:

Donation Cans

Sponsorship

CASA hosted actvities

Bake sale/ car wash

Facebook Fundraiser

Super Kid Flight

Other

Please Discribe:

Thanks for registering!

CASA of Humboldt

2356 Myrtle Ave

Eureka, CA 95501

Phone: (707) 443-3197

Registered Charity: 680243040

Enter your email here

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