BASA Soccer Registration Form

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BASA Soccer Registration Form

Register your child to try-out for the BASA Blazers!

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Enter Your Name (First & Last)

Your answer

Player's Phone Number

Your answer

Player's Email Address (Non-School)

Your answer

Parent/Guardian's Name (First & Last)

Your answer

Parent/Guardian's Phone Number

Your answer

Parent/Guardian's Email Address

Your answer

Second Parent/Guardian's Name (First & Last)

Your answer

Second Parent/Guardian's Phone Number

Your answer

Second Parent/Guardian's Email Address

Your answer

Submit

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