Registration for 2017 Winter Day League (November 2017 – February 2018)
Last Name
First Name
Nickname
Home Phone
Work/Cell Phone
Newsletter Preference:
E-mail
Spouse Name
State
City
Street Address
Postal Mail
Deadline For Receipt of Form & Fees October 28, 2017
Zip
Occupation (Former if Retired)
Date of Birth (MM/DD/YY)
E-mail Address:
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