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BVC (Girls) Summer League Registration - Middle school

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

Zip Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Home Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

$95.00 Player Fee Due before 1st Game.:

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IMPORTANT: Online Payment with credit cards is not active for this form

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