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Client Info Form

 

Client Info Form

Make sure to click on the "Submit" button after you complete form

First Name*

Last Name*

Name as you want it to appear on your video marquee*

Your Street Mailing Address (include bldg, apt or box #)*

City*

State*

Zip*

Phone (include area code)*

Sport

Jersey Number*

Height*

Weight*

What Position(s) Do You Play?

What is Your GPA?

Head Coach's First Name*

Head Coach's Last Name*

School Phone (Include Head Coach's ext no. if applicable)*

School Name*

School Nickname*

School Colors*

School Street Address*

School City*

School State*

School Zip*

Your Email Address: *

Please enter the phrase above

 

 

 

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