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