Columbus United Soccer

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Player Information

* Player First Name:

* Player Last Name:

* Player Address Line 1:

* Player City:

* Player State:

* Player Zip:

* Gender:

* Birth YEAR:

* Player Birthdate:

* Player Phone Number:

Do you play Goalkeeper?

Please enter your previous playing experience::

Parent/Guardian #1 Information

* Parent/Guardian First Name:

* Parent/Guardian Last Name:

* Parent/Guardian Email Address:

Address Line 1:

City:

State:

Zip:

Phone Number:

Parent/Guardian #2 Information

Parent/Guardian #2 First Name:

Parent/Guardian #2 Last Name:

Parent/Guardian #2 Email Address:

Parent/Guardian #2 Address Line 1:

Parent/Guardian #2 City:

Parent/Guardian #2 State:

Parent/Guardian #2 Zip:

Parent/Guardian #2 Phone:

Please enter any additional information you'd like to share::

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