Moxie Summer Camp Registration
Player First Name *
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Player Last Name *
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Player E-mail Address *
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Address *
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City *
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Zip Code *
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Home Phone *
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Parent Name(s)
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Player Mobile Phone *
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Primary Parent Mobile Phone *
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Secondary Parent Mobile Phone *
Your answer
Please select the session(s) your son or daughter will be attending: *
.
Enter your PayPal Transaction ID for proof of payment:
.
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