| Players Name: |
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| Player's jersey # (if known): |
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| Positions played/preferred: |
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| Contact phone #'s: |
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| Contact Email address: |
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| Previous Club Experience: |
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| School attending in the fall: |
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| Grade in School 2011-2012 season: |
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| Parents names:: |
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Playing Schedule:
Please include date, time, location and opponent. |
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