Knuckle Up Sports Inc

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PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Or Cell Phone:

Gender:

Grade:

Age:

Current School:

High School Will Be Attending:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* Cell Phone:

PARENT/GUARDIAN #2

* Parent, Guardian or Adult E-mail:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

WAIVER INFORMATION

*** Insert your waiver information here ***

I/we agree with the above *

Signature:

Date:

* indicates required fields

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