USA U23 Women Registration

Player Name
Gender
MM slash DD slash YYYY
Address
Athlete Shirt Size

Athlete Short Size

How did you hear about this program?

Emergency Contact Information

Emergency Contact Name

Signatures, Disclaimers and Terms of Agreement

Medical Expenses(Required)
Photo Release(Required)
Terms(Required)
Payment Terms(Required)
Signature
By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
MM slash DD slash YYYY

Payment Information

Payment Options
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