• First Name
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• Email Address
• Attendee's First Name
• Attendee's Last Name
• Attendee Date of Birth
• Parent/Guardian's Full Name
• Street Address
• City
• State Select One
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• Zip or Postal Code
• Phone Number w/ Area Code
• High School
• Graduation Year
• Primary Position Select One
  Goalkeeper
  Outside Back
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  Outside Midfielder
  Center Midfielder
  Forward
  
• Secondary Position Select One
  Goalkeeper
  Outside Back
  Center Back
  Outside Midfielder
  Center Midfielder
  Forward
  
• Club Team, Coach, and Contact Info (if applicable)
• T-Shirt Size Select One
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• Roommate Request (Optional - Only 1 Request Permitted)
• I give my permission for my child’s photograph to be used in future brochures. Yes No

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