Player Information
Player NameKash Salsman
Player's Date of Birth02/18/2020
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 namesGavin Wyatt, Jackson Herman
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 NameAshley Salsman
Parent / Guardian EmailEmail hidden; Javascript is required.
Parent / Guardian Cell Phone4025602592
2nd Parent / Guardian NameKody Salsman
2nd Parent / Guardian EmailEmail hidden; Javascript is required.
2nd Parent / Guardian Cell Phone4028020188
Billing Address7306 Fairbanks Pl
Lincoln, NE 68516-9523
United States
Map It
Total$250.00
Payment MethodPayPal Checkout