Henry E. Lackey High School Athletic Booster Member On-line Registration Form

If you would like to become a member of the Henry E. Lackey Boosters Association, please fill out the form below and use the submit button (at bottom of page) to send us your information via e-mail.  Our membership committee will contact you once your information is received.

First

Last Name

Name:

Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Format:999-999-9999

Format:999-999-9999

E-Mail Address:

Occupation:

Parent Teacher Student Administration Coach Other

Please select one:

If Other, specify?

Yes No

Are You a Lackey graduate?

If Yes, Year Graduated?

Please list your Lackey student's name, their grade, and the sport they participate in area below:

Students Name: Grade: Sport(s):

Please list below any Special Talents, Skills, or Hobbies you have:

Special Talents/Skills/Hobbies: