Guardian Name | Anna Louise |
---|---|
Last | Englund |
ale123@me.com | |
Home Phone | 207-761-9939 |
Mobile Phone | 207-233-7045 |
Address | 110 Alice Street |
City | Portland |
State | ME |
Zip | 04105 |
Participant Name | Teddy |
Last | Hanley |
jason.hanley@wexinc.com | |
Home Phone | 207-415-2009 |
Address | 29 Trolly Farm Way |
City | Falmouth |
State | ME |
Zip | 04105 |
Gender | Male |
Date of Birth | September 28, 2003 |
School Grade | 7 |
Weight | 82 |
Choose which one. | I have registered in past years (any program). $0 |
Total Payment | 200 |
Which Team | MS Football (Grades 7-8): $200 |