Moxie Tryout Registration, Spring 2020
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Student name *
High School Graduating Class *
Required
Student date of birth *
MM
/
DD
/
YYYY
School *
Position(s) Played *
Required
Street address *
City *
Zip *
Student email *
Student phone
Parent/Guardian name *
Parent/Guardian Phone *
Parent/Guardian email *
Additional parent/guardian's contact info.
Medications, allergies, mental and/or physical health considerations
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