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ORM TEAM NAME: ______________ TOWN: _____________ SPORT (Boys/Girls): ______________ GRADE: ___ LEVEL: A B C (circle one) LAST NAME FIRST NAME ADDRESS (No PO Boxes) TOWN ZIP (as of: Sep-2006) PHONE BIRTH DATE (if applicable) SCHOOL REMARKS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 HEAD COACH NAME: ______________ ADDRESS: ___________________ PHONE (H): __________ ASST. COACH NAME: ______________ ADDRESS: ___________________ PHONE (H): __________ PHONE (W): __________ PHONE (W): __________ .

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