Player Registration Form
Player Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Current Grade
*
Please Select
3
4
5
6
7
8
9
10
11
Gender
*
Please Select
Male
Female
Parents Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Player Phone Number
Please enter a valid phone number.
By checking the box below you acknowledge that West NE Elite DOES NOT assume liability for player injuries
*
I Agree
Player Fees
prev
next
( X )
Registration Fee
$
50.00
Quantity
1
2
3
4
5
Submit
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