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LA Breakers Tryout Information and Waiver
For Players Interested in Participating in Upcoming Tryouts
Player First Name *
Your answer
Player Last Name *
Your answer
Player Gender *
Player Birth Year *
Parent First Name *
Your answer
Parent Last Name *
Your answer
Parent Contact Email Address *
Your answer
Parent Cell Phone
Your answer
Please tell us where your son or daughter has played soccer this past year. *
Your answer
Player Position(s) *
Your answer
Player Medical Conditions/Allergies we should be aware of *
Your answer
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