Wissinoming Boys Club

4133 Van Kirk St, Philadelphia, PA 19135  l  215-535-9199  l  info@wissbc.com

 



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Wissinoming Boys Club Registration 2010

 

Please enter child's information below:

 

Name:     Date of Birth: (mm/dd/yyyy)

Address:

City:     State:     Zip:

Phone Number:    (xxx-xxx-xxxx)

Gender: Male  Female

Email Address:

Please select one:

Baseball

Softball

T-Ball

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Last Updated  4/12/10