WINTER PROGRAM PLAYER REGISTRATION

PLAYER REGISTRATION
WINTER PROGRAM 2021-2022

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PLAYER Name *

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Last

Player Status *

Returning New

Birth Date (Month, Day, Year) *

boy / girl *

Boy Girl Prefer Not to Say

Parent Name *

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Last

Phone Number *

Email *

PARENT NAME (ADDITIONAL) *

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Last

Email (ADDITIONAL) *

Comment *

Payment Options *

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