Eric Houtman

176,2,2014-07-19 00:14:18,0,0,173.57.196.117,https://thequarterbackranch.com/camp-registration/?camp_name=Fall+QB%2FReceiver+Tuneup&price=175,,USD,Approved,2014-07-19 00:14:19,6345658211,175,,1,12,1,Mozilla/5.0 (Macintosh; Intel Mac OS X 10.9; rv:30.0) Gecko/20100101 Firefox/30.0,active,Fall QB/Receiver Tuneup,$0.00,1,Fall QB/Receiver Tuneup,Price,175,1,175,Eric Houtman,06/06/2000,5’10 “,118lbs,Adult Large,8th,Dawson,CISD,Other,1717 Riviera Ln,Southlake,Texas,76092,United States,Jay Houtman,(817)442-1119,(817)797-1102,jhoutman@verizon.net,
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND I SIGN IT OF MY OWN FREE WILL.,1717 Riviera Ln,Southlake,Texas,76092,United States,XXXXXXXXXXXX7212,MasterCard,175,,,,,,,,,,,,,,,,,,