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2022 Galaxy Academy
Hi there, please fill out and submit this form to express your interest to join a the Academy
9
Questions
START
1
Are you a returning player from previous year
*
This field is required.
YES
NO
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2
Players Name
*
This field is required.
First Name
Last Name
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3
Email
*
This field is required.
example@example.com
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4
Phone Number
*
This field is required.
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5
Date of Birth
*
This field is required.
-
Date
Day
Month
Year
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6
Player Gender
*
This field is required.
Male
Female
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7
Playing Position
Goal Keeper
Field Player
Both
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8
Parent Name
First Name
Last Name
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9
Parent Contact Phone
Area Code
Phone Number
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