East Manchester Galaxy First Team Trial Day Form
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Personal Details
Player Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Player Contact Number
*
Please enter a valid phone number.
Format: 00000000000.
Player E-mail
*
Please enter a valid email address
Home Address
*
Street Address
Street Address Line 2
City
County
Post Code
Please upload your photo
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Playing Information
Main Position
*
Goalkeeper
LB/RB
CB
CDM
CM
CAM
LM/LW/RM/RW
CF/ST
Secondary Position
Previous Clubs Played For (if any)
Medical & Fitness Information
Any Injuries or Medical Conditions?
*
Yes
No
If you answered Yes, please specify
Availability & Consent
Are you available for the trial day? (Yes/No)
*
Yes
No
Do you consent to photography & video recording for club promotion?
*
Yes
No
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