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Basketball Registration 2018
Registration is due by October 19, 2018. Please be sure that you have printed and completed the Rules, Regulations & Covenant form on the web page.
Player's Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Grade Level
Your answer
Address *
Your answer
Parent/ Guardian 1 *
Your answer
Home Number *
Your answer
Mobile Number *
Your answer
Email *
Your answer
Parent/Guardian 2
Your answer
Mobile Number
Your answer
Email
Your answer
Emergency Contact Name & Phone Number *
Your answer
T-Shirt Size *
Please download, read, and sign the Rules, Regulations, & Covenant and return it to Payne Warner. Registration will be void if we do not have your Covenant form on file. *
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