Player Name
First Name
Last Name
Date of Birth
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Month
-
Day
Year
Date
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
Female
Male
Child's headshot photo
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Parent E-mail
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Parent Phone Number
Player Age Group
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6u
8u
10u
12u
13u
Football or Cheer
Offense
Defense
Cheer
School & Grade
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