Player Registration

Player Registration Form

Name of Child

Last Name

Date of Birth

Age

School Name

Grade

Address 1

Address 2

City

State / Province

Postal / Zip Code

Parent/Guardian

Last Name

Daytime Telephone

Email

Emergency Contact

Last Name

Cell Phone

Relationship to Player

If other please specify. If it does not apply, please put N/A

Accident Medical Coverage is second to any other collectible insurance; Primary, if no other insurance is force.

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