Player Information
Player NameCash Loeffel
Player's Date of Birth06/25/2019
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?No
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 NameNatalie Loeffel
Parent / Guardian EmailEmail hidden; Javascript is required.
Parent / Guardian Cell Phone4027700606
2nd Parent / Guardian NameTim Loeffel
2nd Parent / Guardian EmailEmail hidden; Javascript is required.
2nd Parent / Guardian Cell Phone4025704774
Billing Address8259 Emery Ln
Lincoln, NE 68516
United States
Map It
Total$250.00
Payment MethodPayPal Checkout