Click here or on the logo for a printable version of this form and explanation of benefits 

Child's Name 

Parent/Guardian's Name 


City    State    Zip

Phone Number    Email Address 

Gender    Age   

Shirt Size   Birthday  

Cost - $15 for the first child, $10 for each additional child.

Payment options

Bring payment to first game

Mail in a check

We can call you for credit card information  

You can mail your check to the following address:

Missouri Southern Athletics
Attn. Cub Club
3950 E. Newman Road
Joplin, Mo. 64801