* 1. Please provide your player's first name:

* 2. Please provide your player's last name:

* 3. Please provide your player's valid US Lax number:

* 4. Please provide the US Lax Number Expiration Date:

* 5. Parent Name

* 6. Parent Contact Phone Number

* 7. Parent Contact email:

* 8. What school grade is your player entering for the upcoming school year?

* 9. Which tryout date(s) will you attend? Best to attend both so we can have a longer evaluation time.

* 10. Highest level town or club team your player most recently play for?

* 11. Preferred position:

**BE SURE TO CLICK THE "DONE" BUTTON BELOW WHEN FINISHED TO SUBMIT**

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