Basketball Sign-Up
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Player First Name
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Player Last Name
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What is the age of the basketball player?
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Player's Date of Birth
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Street address
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Apartment Number
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City, State, Zip
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What is a phone number of a parent or guardian?
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2nd phone number if required or available.
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Email Address of Parent (if available)
ex)
gfjdreamcenter@gmail.com
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Allergies / Medications or special concerns:
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1. In the event of an emergency, and parent/guardian is unavailable, please notify:
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Phone number of emergency contact named above?
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Relationship to Player
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2. Contact Two. In the event of an emergency, and parent/guardian is unavailable, please notify (must be an adult 18 years or older):
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Phone Number of 2. Emergency Contact
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Relationship to Player
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