2. 
4. Team Name*
5. Manager's Name*
7. Email*
8. Driver's License Number*
10. Date of Birth
11. Phone Number*
13. Mailing Address*
14. City*
15. Zip Code*
17. Please list the name and contact information of one other player / coach who can be contacted in the event of an emergency when the manager cannot be reached.
19. Name*
20. Cell Number*
21. Email Address*
23. Please select the appropriate field, team classification, and day of the week.
25. Kiest Complex Leagues
    -- Select One --Thursday - CoEdThursday - Men's

    These leagues will play their games at the Kiest Complex.

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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field