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Mad City Aqua Stars Registration 2023-2024
Please complete this form to register yourself/your athlete for the 2023-2024 season.
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* Indicates required question
Member Type
*
New Member
Renewal
Required
Athlete First Name
*
Your answer
M.I
Your answer
Athlete Last Name
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Phone
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Athlete Email address
Your answer
U.S Citizen
*
Yes
No
Gender
*
Female
Male
Prefer not to say
Other:
Please Select From The Following
*
Competitive Athlete
Recreational Athlete
Trial Athlete
Required
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