HoopsTest - Cincinnati Youth Collaborative

Saturday Hoops Registration

Personal Information

First Name:*

Last Name*

Street Address:*

Apt No:

City:*

State:*

Zip Code:*

Home Phone:*

Example: 5133635200

Cell Phone:

Example: 5133635200

Work Phone:

Example: 5133635200

Date of Birth:*

Email Address:*

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301 Oak Street | Cincinnati, OH | 45219 | 513-363-5200