METRO ST. LOUIS BASKETBALL LEAGUE ROSTER

Please fill out the roster in its entirety, clearly and mail to Lou Potsou along with your registration form:

Lou Potsou

2439 Wesbay Dr.

St. Louis, MO 63043

Coach Name:___________________________________ Team Name:________________________________ Phone:_____________________

Address: ____________________________________________________ City: _____________________ State:______ Zip:________

Cell Phone: ____________________________ Email Address:_________________________________________________

Player Name (please print clearly) Address City State Zip Email Address (parent and/or player)

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