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Payment Summary

Item Total

Registration Age Group U6-U17

$90.00

 

TOTAL: 

$90.00



Contact Information

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   State:    Zip:



Child Info

* Child's Name:


* Age:


Age Group Requested:

* Date of Birth:


* Gender:

* School:




Parent Info

* Parent's Name:


* Mom's Cell Phone:


* Mom's Email:


* Dad's Cell Phone:


* Dad's Email:


Occupation:




Extra Info

We are a 100% volunteer organization. Because of you we exist! Everyone has something to offer and we appreciate you. Thank you for our 23rd year!

Check here if interested in being a volunteer

Volunteer For:

If "other" - please indicate:


List the names of friends your child would like to be with.

Special Team Request:


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