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Harmony Explosion Northwest

Register Online

Harmony Explosion Northwest Online Registration Form

Please fill out the following information and then submit your payment by June 25th, 2021.

Note: Required fields are marked with *

First Name: *

Nickname: *
NOTE: This will be your name on your name badge! If you do not have a nickname, please enter your first name again.
Last Name: *
Date of Birth: *
Gender: *
Email Address: *

Only one e-mail address please.
Address: *

City:: *
   

State/Pr - Zip/Postal Code: *

Home Phone: *
 
Student Cell Phone:

Is texting you OK?   Yes
 
Parent's Name:
  
Second Parent's Name:
Parent's Email : *

If your parents don’t have an e-mail address, just re-enter yours.
Parent's Phone:

Is texting them OK?   Yes

What's your T-shirt size?
*

Registration Fee:$40.00   U.S. funds
(If you need financial assistance, Register, and then send us an email)

  
CLICK ONLY ONCE!