VARSITY ROSTER
Summer Program Application
HPHA Summer Program Application  Form

Please fill out the form below.  The cost for the program is $350.00.  We accept Visa and Mastercard and add 3% for credit card processing.  You may fax the form to Stan Gardner at 214-528-3373 or mail checks to 4311 Potomac Avenue Dallas, TX  75205.
Name::
Address:
Player Phone Number(cell):
Player email address:
Players Name:
Home Phone:
Mothers Cell:
Mothers email:
Fathers Cell:
Fathers email:
2007-2008 Team:
Postion::
Grade Next Year:
Credit Card Number:
Expiration Date:
Billing Address:
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