Player Information
Player NameLayne Lohmeier
Player's Date of Birth04/06/2021
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?No
Please enter the players/coaches namesTeam 6 - Swanson
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 NameLayne Lohmeier
Parent / Guardian EmailEmail hidden; Javascript is required.
Parent / Guardian Cell Phone7209512944
2nd Parent / Guardian NameBrittney Lohmeier
2nd Parent / Guardian EmailEmail hidden; Javascript is required.
2nd Parent / Guardian Cell Phone7193227060
Billing Address8700 S 51st Street
Lincoln, NE 68516
United States
Map It
Total$250.00
Payment MethodPayPal Checkout