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(Please fill out form completely. Incomplete requests will NOT be evaluated)
Team Name
Age Division:
State
Coach/Manager Name:
Email:
Phone Number:
Address:
City / State / Zip
List any Triple Crown Tournaments played in 2023 (if any):
Number of years team has been together:
Number of games played in 2023
2023 Record
National Championships attended the past two years (what/when/finish):
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