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- NOTE- SCHOOL YEAR is the Grade they will be entering this FALL (2011-2012 school year).
- Teammate requests will not be taken. Each division will be playing at the same time to accommodate ride sharing.

Mail Medical Liabilty Release Form with $85.00 Check (Made out to "RYSBL") To: RYSBL - PO Box 783 - Rogers, MN 55374.

First Name*

Last Name*

Mailing Address*

Grade (2011/2012 School Year)*

GENDER (Boy or Girl)*

Height (Inches)*

Experience (House, Travel, # of Years)

Home Phone*

Parent #1 Name*

Parent # 1 Email *

Parent #1 Cell Phone*

Parent #2 Name

Parent #2 Email

Parent # 2 Cell Phone

Emergency Contact*

Emergency Contact Phone*

Notes / Special Information