Player Information
Player NameBrycen Ledin
Player's Date of Birth10/12/2018
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 NameAmber Ledin
Parent / Guardian EmailEmail hidden; Javascript is required.
Parent / Guardian Cell Phone4022027926
2nd Parent / Guardian NameBranden Ledin
2nd Parent / Guardian EmailEmail hidden; Javascript is required.
2nd Parent / Guardian Cell Phone4024405424
Billing Address2317 Vavrina Ln
Lincoln, NE 68512
United States
Map It
Total$250.00
Payment MethodPayPal Checkout