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Rebels Midget 18 Team Roster
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Players Last Name:
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Players First Name:
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Date of Birth
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Players Cell Phone:
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Address:
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City:
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Zip:
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Home Phone:
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1st E-mail (Main Contact): E-mail billing and updates will be sent. Must be parent or guardian.
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Mothers Name:
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Mothers Cell Phone:
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Mothers e-mail:
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Fathers Name:
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Fathers Cell Phone:
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Fathers e-mail::
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Players Height
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Player Weight
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High School Hockey Team
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Shooting hand
Column 1
Right
Left
Column 1
Right
Left
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Players Cell #
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Players Email
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Requested Jersey Number
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