Register
P
lease complete and submit the following registration. Payment, if required, is due at the first meeting or evaluation. You may optionally pay online now as part of the registration process or later by clicking the Payments link.
Player
Name (First/Last):
Birthday (MM/DD/YYYY):
January
February
March
April
May
June
July
August
September
October
November
December
/
/
Medical Conditions and Allergies:
Parents/Guardians (Primary Contact)
Name:
Email:
Address:
City/State:
AL
AK
AZ
AR
CA
CO
CN
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Home Phone:
(
)
-
Cell Phone:
(
)
-
Parents/Guardians (Optional Secondary Contact)
Name:
Email:
Address:
City/State:
AL
AK
AZ
AR
CA
CO
CN
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Home Phone:
(
)
-
Cell Phone:
(
)
-
Emergency Contact
Name:
Phone:
(
)
-
Registration
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