Tyler Coleman

269,2,2015-01-12 16:47:58,0,0,96.226.193.113,https://thequarterbackranch.com/camp-registration/?camp_name=The+Mental+Game&price=95,,USD,Approved,2015-01-12 16:47:58,6830425094,95,,1,,1,Mozilla/5.0 (Macintosh; Intel Mac OS X 10_7_5) AppleWebKit/537.78.2 (KHTML, like Gecko) Version/6.1.6 Safari/537.78.2,active,The Mental Game,$0.00,1,The Mental Game,Price,95,1,95,Tyler Coleman,05/04/99,5.8,140,AM,10,CHS,Southlake Carroll,Other,832 Longhorn Hollow,Southlake,Texas,76092,United States,Dragon CXC,Kirk Coleman,(817)748-1208,(972)740-3687,imkcoleman@accenture.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.,832 Longhorn Hollow,Southlake,Texas,76092,United States,XXXXXXXXXXXX4208,Visa,95,,,,,,,,,,,,,,,,,