EmailMe Form - 2019 All Star Football Academy

Entering what grade level *

Child's Name *

First Last

Child's Address *

Street Address City State / Province / Region Postal / Zip Code

Child's Birthday *

MM / DD / YYYY

Parent/Guardian #1 *

First Last

Parent/Guardian #1 Relationship to Camper *

Does this Guardian have an address that is different than child's?

Parent/Guardian #1 Address

Street Address City State / Province / Region Postal / Zip Code

Parent/Guardian #1 Cell *

### - ### - ####

Parent/Guardian #1 Work Phone

### - ### - ####

Parent/Guardian #1 Place of Business *

Parent/Guardian #1 Email *

Is there a second Parent/Guardian to add?

Yes

No

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