Student Name *

First Name

Last Name

Team *

Boys

Girls

Parent/Guardian Name *

First Name

Last Name

Cell Phone *

(###)

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Home Phone

(###)

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Emergency Contact Name *

First Name

Last Name

Cell Phone *

(###)

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Signature *

I understand that checking this box and providing my name below constitutes a legal signature and that my FACTS account will be charged $280 when the season starts.