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Brookline JP Patriots Pop Warner
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PLAYER INFORMATION
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*
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Email:
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K
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PARENT/GUARDIAN #1
Firstname:
Lastname:
EMail:
Home Phone:
Work Phone:
Cell Phone:
PARENT/GUARDIAN #2
Firstname:
Lastname:
Email:
Home Phone:
Work Phone:
Cell Phone:
MEDICAL/EMERGENCY CONTACT INFORMATION
Emergency Contact:
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Relationship to Player:
Insurance Carrier:
Policy #:
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