2019 Basketball Registration Form
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Church Name: *
District: *
Pastor's Name: *
Participants Name: *
Age: *
City:    State:   Zip:   *
Day Phone:                       Email: *
Please mark the level/category you will be participating in: *
If there is someone in y our district that will be in attendance: Tuesday, Wednesday or Thursday that would like to be a judge or referee please list their name below. (A coach may not act as a judge or referee.)
Contact Pastor Charles Robinson additional recreational questions or list your questions below.
Additional Questions:
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