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* 1. Your Name

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* 2. Primary Contact Number

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* 3. Primary Email Address

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* 4. Division/Age Group

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* 5. Participant Name(s) - If you have a child playing.

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* 6. Assistant Coach Name

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* 7. Assistant Coach Participant Name(s) - If they have a child playing.

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* 8. Suggested Team Name(s) - The Athletic Office will take your request in consideration but will have final say in team name selections.

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