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2016 USBOXLA Nationals Individual Player Sign Up Form
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* Indicates required question
PLAYER'S NAME
*
(LAST, FIRST)
Your answer
EMAIL ADDRESS (ES)
*
SEPARATE WITH A COMA
Your answer
DATE OF BIRTH
*
MM
/
DD
/
YYYY
YOUR POSITION
*
DEFENSE
OFFENSE
GOALIE
DOMINATE HAND
*
LEFT
RIGHT
WHAT CITY DO YOU LIVE IN?
*
Your answer
WHAT SCHOOL DISTRICT IS YOUR SON/DAUGHTER IN?
Your answer
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