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S Boy's Soccer Girl's Soccer Boy's Volleyball Girl's Volleyball Boy's Football Girl's Cheerleading FIRST NAME: Boy's Basketball Girl's Basketball MIDDLE INITIAL: ADDRESS: Girl's Softball Boy's Baseball LAST NAME: ZIP CODE: SCHOOL: TELEPHONE: GRADE: DATE OF BIRTH: Boy's Track Girl's Track AGE: PLACE OF BIRTH: (CITY & STATE) PARENT'S EMAIL ADDRESS: PLEASE CHECK ONE: NO RESTRICTIONS RESTRICTIONS (List below) List on any physical handicaps which would prohibit this participant fro.

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