Team____________________________________________ Team Name __________________________________

Date ____________________ Childís name ____________________________________ Jersey Number _______

Name __________________________________________________________________________________ Phone ___________________________________

Address ___________________________________________________________ Email: ________________________________________________________

City ______________________________________________________________ , State ______________________ Zip ______________________________


Memory Mates include a 5 X 7 Team photo and a 3 X 5 Individual photo with Team Name and Logo with individualís name.


(Not responsible for illegible writing) (PLEASE PRINT) (All information on form is necessary. Please complete fully.)

[This is an example of the form you will receive when we are scheduled to photograph your player's team and individual photograph.]

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