Sign-Up Online

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" height=30 BGCOLOR="#FF6600" TEXT="#080000" background="060785a3.jpg"> <div> <A HREF="index.htm" TARGET="_top" TITLE="Gillespie / Mt. Olive Eagles Wrestling "><U><B>Home</B></U></A><B>  *  </B><A HREF="schedule.htm" TARGET="_top" TITLE="Schedule"><U><B>Schedule</B></U></A><B>  *  </B><A HREF="pictures.htm" TARGET="_top" TITLE="Team Pictures"><U><B>Pictures</B></U></A><B>  *  </B><A HREF="sponsors.htm" TARGET="_top" TITLE="Sponsors"><U><B>Sponsors</B></U></A><B>  *  </B><A HREF="id20.htm" TARGET="_top" TITLE="Member list"><U><B>Member list</B></U></A><B>  *  </B><A HREF="id25.htm" TARGET="_top" TITLE="Related Links"><U><B>Related Links</B></U></A><B>  *  </B><A HREF="http://pub28.bravenet.com/forum/2342971690" TARGET="_top" TITLE="http://pub28.bravenet.com/forum/23429716"><U><B>Message Board</B></U></A></div> </td> </tr><tr> <td valign="top" height=450 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Sign-Up Online</I></div> <bR> <bR> <bR> <div>  <form method="post" enctype="multipart/form-data" action="http://pub28.bravenet.com/emailfwd/senddata.php"> <input type="hidden" name="usernum" value="2342971690"> <input type="hidden" name="cpv" value="2">  <table border="0" cellpadding="0" cellspacing="0" align="center"> <tr> <td><h3 style="border-bottom:1px solid black;">Pre Sign-Up Registration</h3></td> </tr> <tr> <td> <label for="name" style="float:left;width:140px;">Childs Name:</label><input type="text" name="name" id="name" value="" maxlength="25" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="age" style="float:left;width:140px;">Childs Age:</label><input type="text" name="age" id="age" value="" maxlength="2" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="grade" style="float:left;width:140px;">Grade in 2009:</label><input type="text" name="grade" id="grade" value="" maxlength="2" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="weight" style="float:left;width:140px;">Approximate Weight For Singlet</label><input type="text" name="weight" id="weight" value="" maxlength="3" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="b-day" style="float:left;width:140px;">Childs Birthday:</label><input type="text" name="b-day" id="b-day" value="" maxlength="25" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="experience" style="float:left;width:140px;">Prior experience or sports played:</label><textarea name="experience" id="experience" style="width:350px;height:150px;"></textarea><div style="clear:left;height:20px;"> </div> <label for="parents" style="float:left;width:140px;">Parents Names:</label><input type="text" name="parents" id="parents" value="" maxlength="50" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="addy" style="float:left;width:140px;">Home Address:</label><textarea name="addy" id="addy" style="width:350px;height:150px;">rnrn</textarea><div style="clear:left;height:20px;"> </div> <label for="phone" style="float:left;width:140px;">Contact Phones:</label><textarea name="phone" id="phone" style="width:350px;height:150px;"></textarea><div style="clear:left;height:20px;"> </div> <label for="replyemail" style="float:left;width:140px;">Email Address</label><input type="text" name="replyemail" id="replyemail" value="" maxlength="50" style="width:200px;"><div style="clear:left;height:20px;"> </div> <label for="Volunteer" style="float:left;width:140px;">Are parents willing volunteer at fundraising events? Or do you have any talents that may come in useful for the club?</label><textarea name="Volunteer" id="Volunteer" style="width:350px;height:150px;"></textarea><div style="clear:left;height:20px;"> </div> <label for="Permissions" style="float:left;width:140px;">Can we add your child to our member list online?</label><input type="text" name="Permissions" id="Permissions" value="" maxlength="25" style="width:50px;"><div style="clear:left;height:20px;"> </div> <label for="coach" style="float:left;width:140px;">Can you help coach?</label><input type="text" name="coach" id="coach" value="" maxlength="25" style="width:50px;"><div style="clear:left;height:20px;"> </div> </td> <tr> <td align="right">  <input type="submit" value=" Submit "> <input type="reset" value=" Reset "> </td> </tr> </table> </form>  </div> </td> </tr></table></body>