| Player Information | |
|---|---|
| Player Name | Yaretzi Terrazas |
| Player's Date of Birth | 05/02/2019 |
| Do you have another player to register? | Yes |
| 2nd Player's Name | Joaquin Terrazas |
| 2nd Player's Date of Birth | 09/30/2020 |
| Do you have a player/coach that you would like to be on the same team with? | Yes |
| Please enter the players/coaches names | Team 6 - Swanson |
| Player Registration | Player Registration, Qty: 2, Price: $250.00 |
| Waiver of Liability, Release, Assumption of Risk & Indemnity Agreement | By submitting this I accept the terms of the aforementioned Waiver of Liability, Release, Assumption of Risk & Indemnity Agreement. |
| Parent-Guardian Information | |
| Parent / Guardian Name | Kathy Terrazas |
| Parent / Guardian Email | Email hidden; Javascript is required. |
| Parent / Guardian Cell Phone | 402-613-5457 |
| 2nd Parent / Guardian Name | Alan Terrazas |
| 2nd Parent / Guardian Cell Phone | 402-610-4463 |
| Billing Address | 2210 SW Paul Whitehead Ln Lincoln, NE 68522 United States Map It |
| Total | $500.00 |
By submitting this I accept the terms of the aforementioned Waiver of Liability, Release, Assumption of Risk & Indemnity Agreement.