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Registration Form - 2018

Fill in the form below and click the 'Send' button. The information provided will be used
to provide you with a pre-printed form at registration time.
---- Players Info ----
First Name:   Mid Name:   Last Name:
Birthdate:   Gender:         Home Phone:
Contact #:     EMail Address:
Mailing Address:
Physical Address:
City: State: Zip:
School: Grade:   Player Lives With :
---- Fathers Info ----
Name: Cell #:     Other #:
EMail:
---- Mothers Info ----
Name: Cell #:     Other #:
EMail:
---- Insurance Info ---- ---- Champions League ----
Doctor:     Special Needs?  
   
 
       

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Last updated 29 June 2017
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