7 on 7 Team Dimes 15u Registration Form

7 on 7 Registration Form 15u Team Dimes
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Athlete Information
Athlete's Name
First NameLast Name
Athlete's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Birth date
MonthDayYear
Age
Jersey Top Size
small, Medium, Large, etc...
Short Size
Parent/Guardian Information
Name
First NameLast Name
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name
First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

7 on 7 Registration Form 15u Team Dimes