REBELS SQUIRT MAJOR TEAM REGISTRATION

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REBELS SQUIRT MAJOR TEAM REGISTRATION

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Players Last Name: *

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Players First Name: *

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Players Date of Birth: *

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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 E-mail:

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Mothers Cell Phone:

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Fathers Name: *

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Fathers E-mail:

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Fathers Cell Phone:

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