Site: ___ Lakota ____Sycamore ______ Cup Birthdate Range: (ie 2000-2001):_______________________ Team Gender: _____ Boys ______ Girls The following information will be used for contact purposes. Team Identifier (ie Administrator Name/Coach/Team Name): ________________________ SSN: ___________________________ Date of Birth____________________________ ______________________ Issue Date: __________________________ Driver’s License # Team Administrator’s Address (No PO Box:)______________________________________ _____________________________________________________________________________ Email Address: _______________________________________ Team Other Number_________________ Admin’s Home Phone:_____________________
Site: ___ Lakota ____Sycamore ______ Cup Birthdate Range: (ie 2000-2001):_______________________ Team Gender: _____ Boys ______ Girls The following information will be used for contact purposes. Team Identifier (ie Administrator Name/Coach/Team Name): ________________________ SSN: ___________________________ Date of Birth____________________________ Driver’s License # ______________________ Issue Date: __________________________ Team Administrator’s Address (No PO Box:)______________________________________ _____________________________________________________________________________ Email Address: _______________________________________ Team Admin’s Home Phone:_____________________ Other Number_________________