Mile High Vision Youth Outreach

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Player Registration


Player Information


First Name:     Last Name:

Birth Date:     Gender:   Male:     Female:

Zip Code:

Desired Jersey Number (Choose 3):
Choice 1:   Choice 2:   Choice 3:


Parent Information


Parent 1:
First Name:     Last Name:

Email:     Phone:


Parent 2:
First Name:     Last Name:

Email:     Phone:

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