We just need a little bit of information to get started.
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PLAYER - name *

 
PLAYER - email address (if available) *

 
PLAYER - prior experience? (yes or no) *

 
Grade *

 
Birthdate *

 
Address, City, Zip *

 
MEDICAL INFORMATION – Insurance Carrier name *

 
MEDICAL INFORMATION – Insurance Policy Number *

 
MEDICAL INFORMATION – List any Allergies *

 
MEDICAL INFORMATION – List any Medical Conditions *

 
MEDICAL INFORMATION – List any Medications *

 
*PARENT 1 - EMERGENCY CONTACT (First and Last name)

* *

 
*PARENT 1 - EMERGENCY CONTACT - email

* *

 
*PARENT 1 - EMERGENCY CONTACT - phone

* *

 
*PARENT 2 - First and Last name

*

 
*PARENT 2 - email

*

 
*PARENT 2 - Phone

*

 
*Are there any other contacts you would like us to send game and practice information to? (Name and email address)

*

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