Join The Bradfield Dads Club Registration "*" indicates required fields 1Info2Children3Dues4Payment Name* First Last Email Address* Phone Number*Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please let us know your children’s names so we can make sure your donation is credited appropriately. Child Name 1* First Last Child Name 2 First Last Child Name 3 First Last While the recommended donation is $175 per child, we appreciate any donation. Recommended Donation Per Child Price: Number of ChildrenPlease enter a number from 0 to 5.Please enter the number of children above.Other Donation Total Donation: Please double check your total donation amount before submitting your orderTotal Credit Card*Card Details Cardholder Name Δ
