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Winter League (Session 3)
*
Gender:
Boys
Girls
*
Division:
3rd
4th
5th
6th
7th
8th
*
Team Name::
*
Coach/Contact Name::
*
Coach/Contact Phone Number::
*
Coach/Contact Email::
Scheduling Restriction: (try to limit to one, we will try to accommodate):
Credit Card Information
Cardholder Name::
Street Address::
Zip/Postal Code::
Card Number::
Card Expiry Month::
01
02
03
04
05
06
07
08
09
10
11
12
Card Expiry Year::
24
25
26
27
28
29
30
31
32
33
34
35
CVV Security Code::
Payment Amount::
* indicates required fields