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St. Pius X Men's Club Registration 

Name:

 

 

 Mailing Address:

 

 
Email:

 

 

 Facebook:

 

 
Home Phone:

 

 

 Mobile Phone:

 

 
Wife's name:

 

 

 Wife's Phone:

 

 
Other phone:

 

 

 Specify:

 

 
  Do you have children at St. Pius X?

Yes   No

   If so, please list their names & grades for 11-12 school year:

 
  Do you have (and would you loan on occasion) any of the following:    
Trailer:

 

 

 Yes   No

What size?

    
Bobcat:

 

 Yes   No

 

    
Crawfish boil stuff (pots, etc):
 		 Yes   No

Which items?

    
Pressure washer:
 		 Yes   No

 

    
  Anything you can think of that we overlooked:

 

    

Please review your information before submitting.