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437 Goldfloss St., Winston-Salem, North Carolina 27127

K-5 Intramural Basketball Registration

Child's Date of Birth
Month
Day
Year
Child's Grade Level
Kindergarden
1st
2nd
3rd
4th
5th
Child's T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Small
Medium
Large
Extra Large

Emergency Contact Information

Registration Fee
$65

Registration includes a T-shirt.

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