Spartan Women's Basketball Individual Camp registration

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Email address *

First name *

Last name *

Address 1 *

Address 2

City *

State *

ZIP Code *

Cell Phone Number

Age *

School Attended

Grade in Fall 2019 *

Position *

T-shirt size *

Parent/Guardian *

Parent/Guardian Phone Number *

Make checks payable to:

Southwestern Community College
Attn: Bryan Austin
1501 W. Townline St.
Creston, IA 50801

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