Youth eSports League National Championship & Conference Pre-Registration

Attendee Information

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* 1. First Name:

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* 2. Last Name:

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* 3. Email Address

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* 4. What is your gender?

Female

Male

Non-Binary (Gender-Fluid)

Transgender Man

Transgender Woman

Do not wish to disclose

Other (please specify)

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* 5. I will be within this age range on June 11, 2021:

5 to 12

13 to 17

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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* 6. What is your zip code/postal code?

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* 7. What country do you live in?

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* 8. I am a...

Student

Parent/Guardian

Youth Worker