MCLA Women's Basketball Summer Clinic Registration
Email
Secondary Email
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Parent or Guardian (s) names *
Email address *
Mailing Address (Street, City, State, Zip) *
Home Phone Number *
Emergency Phone Number (during Camp Hours) *
Child's Name *
My child is entering which grade *
3rd
4th
5th
6th
7th
8th
9th
Name of school *
Insurance Company and Policy Number *
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