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Player Name: __________________________________________________
Address : __________________________________________________ Birthdate: __________________
Address 2: __________________________________________________ League Age: __________________
City/State/Zip:__________________________________________________ Gender: __________________
Home Phone: __________________________________________________ League: __________________
Email: _________________________________________________ League Fee: __________________
Parent #1 Parent #2
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Name _______________________________ Phone _______________________________ Email _______________________________ Occupation ________________________________ |
Name _______________________________ Phone _______________________________ Email _______________________________ Occupation _______________________________ |
Medical Information Travel Team Information
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Emergency contact _________________________________ Phone ______________ Relationship to player _________________________________ Insurance carrier _________________________________ Policy ______________ |
Birth certificate Yes No Prior Travel Exp. Yes No Current Level ___________ |
Parent
Volunteer Options
Coach _____ Asst Coach _______ Auxiliary _______Field Maintenance _______ Referee_______
Please volunteer. Any time you can give is greatly appreciated. Help us make a difference in our youth.
In-House
Travel
Travel & In-House
Signature ___________________________________________________ Date __________________
Shirt ________ Shorts _________ Amt Pd___________ How Pd _________ League Official ____