Durand Little Dribblers Sign-up 23-24
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Email *
Child's Name (First and Last) *
Child's Grade level 
Childs Shirt size  *
Parent's Names (First and Last) *
Parent's Phone # *
Parent's Email Address (If additional parent needs to be contacted please provide both emails here.)   *
Emergency Contact (Name and Phone #) *
Does your child have any medical conditions or anything our coaches would need to know?
I, the parent of (child named above) , authorize him/her to take part in the youth basketball activity (Little Dribblers). I also authorize any emergency examinations or medical treatment that may be needed by a licensed physician. I will not hold the sponsors, coaches, staff, or administration/facilities responsible for any injuries that may occur while my child participates in this event. *
As a reminder - Please bring cash or check of $30.00 at the first practice on Nov 8th, 6PM at Durand-Arkansaw HS.  Make checks payable to Durand Girl's and Boy's Basketball club. 
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