Player Information
Player NameColson Borchers
Player's Date of Birth07/13/2019
Do you have another player to register?No
Do you have a player/coach that you would like to be on the same team with?Yes
Please enter the players/coaches namesTeam 10 - Evans
Player RegistrationPlayer Registration, Qty: 1, 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 NameAmy Borchers
Parent / Guardian EmailEmail hidden; Javascript is required.
Parent / Guardian Cell Phone4022762676
2nd Parent / Guardian NameThadeus Borchers
2nd Parent / Guardian EmailEmail hidden; Javascript is required.
2nd Parent / Guardian Cell Phone4022762320
Billing Address1200 Hickory Street
Hickman, Ne 68372
United States
Map It
Total$250.00
Payment MethodPayPal Checkout