| Guardian Name | Brandi |
|---|---|
| Last | Hau |
| Brandi@Cousineaus.com | |
| Home Phone | 207-899-4777 |
| Mobile Phone | 207-860-8001 |
| Address | 22 Twin Meadows Lane |
| City | Falmouth |
| State | ME |
| Zip | 04105 |
| Participant Name | Dominic |
| Last | Hau |
| Brandi@Cousineaus.com | |
| Home Phone | 207-899-4777 |
| Mobile Phone | 207-860-8001 |
| Address | 22 Twin Meadows Lane |
| City | Falmouth |
| State | ME |
| Zip | 04105 |
| Gender | Male |
| Date of Birth | September 16, 2007 |
| School Grade | 3 |
| Weight | 60 |
| Choose which one. | I have registered in past years (any program). $0 |
| Total Payment | 100 |
| Which Team | Pee Wee Football (Grades 2-3): $100 |
Boosters in Falmouth, Maine
