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Affiliation For Inspiring Youth Upliftment Program

July 10, 2022 -

August 7, 2022

Tournaments

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Team Registration - Affiliation For Inspiring Youth Upliftment Program

Participants First Name *

Participants Last Name *

Date of Birth *

yyyy-mm-dd

Address *

City *

Postal Code *

Country *

Province *

Phone *

Email *

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Team Name *

Team Colour *

Team Alt. Colour *

Team Passcode *

Team members will be required to enter this code exactly before joining within their form submission. (case sensitive)

Soccer Position

Volleyball Position

Referred By

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Emergency Contact Info

Contact Name *

Contact Phone Number *

Relationship *

By submitting this registration you acknowledge that you have read this agreement, that you have executed this agreement voluntarily, and that this agreement is to be binding upon yourself, your heirs, executors, administrators and representatives.

Notes

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Payment Info

Premium Redemption Code

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Gross Amount

Payment Method
Paypal

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