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Email *
Athlete First and Last Name *
Athlete Phone Number *
Athlete Nickname (must be appropriate)
Current Grade *
Athlete Birthday *
MM
/
DD
/
YYYY
Tee Shirt Size *
Mothers First and Last Name *
Mothers Phone Number *
Mothers Email Address *
Home Address *
Fathers First and Last Name *
Fathers Phone Number *
Fathers Email Address *
Emergency Contact Name (other than parent) *
Emergency Contact Phone Number *
Other clubs/organizations involved in: *
List any food allergies and/or medical needs the coaches should be aware of: *
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