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Jewish Youth Basketball League
REGISTRATION FORM
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* Indicates required question
Email
*
Your email
Player Name
*
Your answer
*
Male
Female
Birth Date
*
MM
/
DD
/
YYYY
Current Grade
*
Choose
5th Grade
6th Grade
7th Grade
School
*
Your answer
T-Shirt Size (Youth Sizes)
*
Choose
XS
S
M
L
XL
XXL
Parent Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Please enter your credit card information below to pay the $40 registration fee (T-Shirt included!):
Credit Card Number
*
Your answer
Expiration Date
*
Your answer
Billing Address
*
Your answer
Billing Zip Code
*
Your answer
Please let us know in the space below if there is any additional information about your child that we should be aware of:
Your answer
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