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Get and Sign Uysa Affinity Form
INFORMATION
Player’s Name (First/ MI /Last)
Gender
Elementary School
Grade
DOB (MM/DD/YYYY)
Shirt Size
Short Size
/_
/
Sock Size
Emergency Contact (Other than Parent)
Telephone(_
)_
Doctor to Notify in an Emergency
Telephone(
)
List Medical Problem/Prohibition Player Has
I WOULD LIKE TO HELP BY VOLUNTEERING
Coach
Assistant Coach
Team Manager
Team Parent
Special Project
Fund Raising
Field Preparation
Referee
CONSENT FOR MEDICAL TREATMENT
As parent or legal guardian of...
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