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Please Choose a Region *

Team Name *

20 Characters Max

Team Captain Name *

First

Last

Captain Nickname

7 letters max

Captain Phone Number *

Captain Email *

Player 2 Name *

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Last

Player 2 Nickname

7 letters max

Player 2 Phone Number

Player 2 Email

Please add any subs, if needed.

Sub 1 Name

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Last

Sub 1 Phone Number

Sub 1 Email

Sub 2 Name

First

Last

Sub 2 Phone Number

Sub 2 Email