REGISTRARSE

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Select Age Group*

10 & Under (WAITLIST)

13 & Under (WAITLIST)

16 & Under (WAITLIST)

Child's First Name*

Child's Last Name*

Child's Birthday*

Día

Mes

Año

Will you be joining with teammates or individually?*

Enter teammate(s) full name(s) below, if applicable. *

Parent's Email*

Parent's First Name

Parent's Last Name

Parent's Phone Number*

Home Address*

How did you hear about us?*

Instagram

Facebook

Google

Tiktok

Word of Mouth

Flyer / Banner

Coach / Rec Team

Instagram Handle

Reservation + Online Processing Fee

10,75 US$

ImpactYouthLeagueMNY@gmail.com

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