2019 Gold Academy Registration
First Name *
Your answer
Last Name *
Your answer
Male or Female? *
Date of Birth (MM/DD/YYYY) *
Your answer
Player Email Address *
Your answer
Player Cell Number *
Your answer
Parent Name #1 *
Your answer
Parent #1 Email Address *
Your answer
Parent #1 Cell Number *
Your answer
Parent Name #2
Your answer
Parent #2 Email Address
Your answer
Parent #2 Cell Number
Your answer
Club Team
What high school do you play with? (if you play/will be playing high school)
Your answer
What position do you mostly play in 15's?
Important Medical Concerns
Your answer
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