| Grade Division and Gender: |
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| Player First Name: |
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| Player Last Name: |
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| Address Street 1: |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Daytime Phone: |
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| Email: |
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| Parent or Guardian: |
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| School: |
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| Coach's name or need coach: |
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| Insurance type: |
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| Special Medical or Other Requests: |
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| I, as guardian, certify my child is capable of safe participation in the Trinity League and is in normal health. I assume all normal risks associated with playing basketball in the safe environment of the Trinity League. I authorize Trinity to obtain medical treatment in the case of an emergency: |
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| Donate- Whould you like to donate to the scholarship fund? $10-$50?: |
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| Total Payment= $90 (3-8) or $80 (K-2) + $20 (Jersey Fee)+ Donation: Can be given to your coach or sent to address below: |
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