New Player Registration for Winter 3 and 4

Parent / Legal Guardian Name *

First

Last

Parent / Legal Guardian Email *

Parent / Legal Guardian Phone Number *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Player Name (Child 1) *

First

Last

Child 2

First

Last

Child 3

First

Last

Program Options *

Daily Option - $40 (Please write Dates below)

*One Day might not be available if 14 participants are filled.

Payment Option *

Emergency Contact Name / Phone Number / Relationship *

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