Player Questionnaire

Player Name *

First Name

Last Name

Age Group *

12U

13U

14U

15U

16U

Player Birthdate *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Player Phone

By providing a phone number, I hereby consent to receiving occasional text messages from Pantera.

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What other extracurricular activities do you participate in?

Check any that apply

None

Basketball

Cheerleading / Dance

Choir / Theatre

Church

Orchestra / Band

Softball

Tennis

Track

Other

Parent 1 Name *

First Name

Last Name

Parent 1 Phone *

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Parent 2 Name

First Name

Last Name

Parent 2 Phone

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Today's Date *

MM

DD

YYYY