Ambassadors Pittsburgh East End Registration
This form is to register for Ambassadors Pittsburgh East End Community Program. If you have any questions please email us at pgh@ambassadorsfootball.org or call Melia Major at (412)583-5674.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Date of Birth *
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DD
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YYYY
Gender *
Child's School *
Your answer
What is your child's t-shirt size? *
Date of last tetanus shot: *
Your answer
Does your child have allergies to:
Does your child suffer from, or ever experienced, or is being currently treated for any of the following?
Additional Info:
Your answer
Are you registering more than one child? *
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