Jacob Gutierrez

183,2,2014-08-05 14:05:03,0,0,172.56.6.84,https://thequarterbackranch.com/camp-registration/?camp_name=Fall+QB%2FReceiver+Tuneup&price=175,,USD,Approved,2014-08-05 14:05:03,6390373894,175,,1,,1,Mozilla/5.0 (Linux; U; Android 4.3; en-us; SGH-T999 Build/JSS15J) AppleWebKit/534.30 (KHTML, like Gecko) Version/4.0 Mobile Safari/534.30,active,Fall QB/Receiver Tuneup,$0.00,1,Fall QB/Receiver Tuneup,Price,175,1,175,Jacob Gutierrez,11-4-00,5’5″,105,Adult small,8th,Trinity Springs Mid.,Keller isd,Baseball,Basketball,5001 Golden Triangle blvd. #623,fort worth,Texas,76244,United States,Luis Gutierrez,(469)878-9896,(469)878-9896,lgut80@gmail.com,
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.,5001 Golden Triangle blvd,apt. 623,fort worth,Texas,76244,United States,XXXXXXXXXXX1005,American Express,175,,,,,,,,,,,,,,,,