Manitoba Selects Deposit
FOR INVITES ONLY
Attention:
IF YOU HAVE NOT BEEN INVITED PLEASE DO NOT FILL THIS FORM OR SEND A DEPOSIT!
Please give us the name of the SCOUT who invited you?
*
Player Name
*
First Name
Last Name
Date of Birth
*
Month/Date/Year
Age
*
Club Team or Highschool Team
*
Positons Played
*
What team are you playing with?
*
10U
13U
Highschool Jr 07-08
Highschool Sr 05-06
T-Shirt Size?
XS
S
M
L
XL
2XL
3XL
4XL
Instagram Account
Player resides with who?
*
Parent #1
Parent #2
Both
Guardian
Parent #1 or Guardian
*
First Name
Last Name
E-mail
*
Phone Number
*
Home address
*
Street name, city, province, postal code
Parent #2 or Guardian
First Name
Last Name
E-mail
example@example.com
Phone Number
Home address
Street name, city, province, postal code
My Products
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Selects Travel Deposit
$
375.00
CAD
Save your spot & Start fundraising NO REFUNDS
Enter coupon
Apply
Total
$
0.00
CAD
Submit
Should be Empty: