Mad City Aqua Stars Registration 2019-2020
Please complete this form to register yourself/your athlete for the 2019-2020 season.
Member Type *
Required
Athlete First Name *
Your answer
M.I
Your answer
Athlete Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Athlete Email address
Your answer
U.S Citizen *
Gender *
Please Select From The Following *
Required
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