Climbing Team Registration and Billing Agreement Climbing Center*SELECT ONEGolden Climbing CenterRockville Climbing CenterTimonium Climbing CenterCrystal City Climbing CenterMulti Gym (All Locations)Which Team?*SELECT ONEIntermediate Climbing TeamAdvanced Climbing TeamTeam Earth TreksHow many practice days per week?*SELECT ONE1 day a week (Saturdays)2 days a week (Sat + Thurs)3 days a week (not currently available)Is the team member an Earth Treks Member?Yes - MemberNo - Non MemberThe youth participating in the team must be an active Earth Treks member with ongoing monthly dues to receive member team dues pricing.For those participants who are not annual members, team dues will be processed on the 1st of each month (or the first business day) via credit card. You must separately provide your credit card information via the secure Change my Billing Information Form. Indicate in the message box of the billing form that you are providing billing info for a team registration and are not members. You do not need a membership account to use this form.Authorized Monthly Intermediate Team Dues - MemberMember - Intermediate Team ($65/month)Authorized Monthly Intermediate Team Dues - Non MemberNon Member - Intermediate Team ($95/month)Authorized Monthly Advanced Team Dues - MemberMember - Advanced Team ($95/month)Authorized Monthly Advanced Team Dues - Non MemberNon Member - Advanced Team ($125/month)Authorized Monthly Team Earth Treks Dues - MemberMember - Team Earth Treks ($125/month)Authorized Monthly Team Earth Treks Dues - Non MemberNon Member - Team Earth Treks ($175/month)Team Member Name* First Last Date of Birth* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Guardian Name* First Last Guardian Phone*Alternate PhoneGuardian Email* Enter Email Confirm Email Guardian Name 2 First Last Guardian 2 PhoneGuardian 2 Email Enter Email Confirm Email Team Member Email Enter Email Confirm Email Optional - Include this information only if you want your child to receive group team emails.Would you like us to share parental contact info with other parents?No thank you.Yes.Earth Treks may share parental contact information (phone / email) with the team parents at large to aid in communication, arranging carpools, etc.Which team shirt style do you want?*Cotton Team ShirtsWicking Polyester Shirts (Additional cost noted above)Cotton team t-shirts are included in the one time registration fee. Cotton shirts are available as regular t-shirts or uni-sex tanks. You have an option for upgrading the shirts to a wicking polyester fabric instead (t-shirts only). Polyester t-shirt orders will increase the normal one time registration fee to: Intermediate - $25, Advanced - $42, Team ET - $55.Cotton Short Sleeve or Tank?Cotton Short Sleeve T-ShirtCotton Unisex or Women's racerback TankWhat size cotton t-shirts?SELECT ONEYouth Size Small (6/7)Youth Size Medium (8)Youth Size Large (10/12)Youth Size XL (14/16)Ladies SmallLadies MediumLadies LargeMens XSMens SmallMens MediumMens LargeMens XLShirt #1 Size?*SELECT ONEYouth Size Small (6/7)Youth Size Medium (8)Youth Size Large (10/12)Youth Size XL (14/16)Ladies SmallLadies MediumLadies LargeMens XSMens SmallMens MediumMens LargeMens XLShirt #2 Size?*SELECT ONEYouth Size Small (6/7)Youth Size Medium (8)Youth Size Large (10/12)Youth Size XL (14/16)Ladies SmallLadies MediumLadies LargeMens XSMens SmallMens MediumMens LargeMens XLShirt #3 Size?*SELECT ONEYouth Size Small (6/7)Youth Size Medium (8)Youth Size Large (10/12)Youth Size XL (14/16)Ladies SmallLadies MediumLadies LargeMens XSMens SmallMens MediumMens LargeMens XLWhat size cotton tanks?SELECT ONEUnisex XSUnisex SmallUnisex MediumUnisex LargeWomen's Racerback SmallWomen's Racerback MediumWomen's Racerback LargeThere are two style options - unisex/men's sizing and women's racer back cut.What size polyester t-shirt?SELECT ONEYouth Size Small (6/8)Youth Size Medium (10/12)Youth Size Large (14/16)Youth Size XL (18/20)Ladies XSLadies SmallLadies MediumMens XSMens SmallMens MediumMens LargeAny Comments or Questions?Registration and Billing Agreement Acknowledgment* Agree I acknowledge that I have read the Parent Handbook and Team Code of Conduct and will help support those standards and policies, including competition supervision, communication and transportation expectations and Earth Treks' Youth Protection policies. I authorize Earth Treks to process for payment my selected monthly team dues and any purchases made on-account and understand that dues will be charged automatically on a monthly basis September thru June unless I notify Earth Treks to suspend dues. I understand that competition coaching fees will be charged (Divisionals - $75 and Nationals - $150) if my child is invited and chooses to participate in one of these competitions. Coaching for local and regional competitions is included in the monthly dues.NameThis field is for validation purposes and should be left unchanged.