Player Information
Player NameBrantley Martin
Player's Date of Birth01/16/2020
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 namesTeam 4 - Watson
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 NameZach Martin
Parent / Guardian EmailEmail hidden; Javascript is required.
Parent / Guardian Cell Phone402-318-2989
2nd Parent / Guardian NameKenzie Martin
2nd Parent / Guardian EmailEmail hidden; Javascript is required.
2nd Parent / Guardian Cell Phone402-730-5244
Billing Address5342 Tipperary Trl
Lincoln, NE 68512
United States
Map It
Total$250.00
Payment MethodPayPal Checkout