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Nebraska Select Pre-Registration Form
Fall 2023 Season
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* Indicates required question
Player First Name
*
Your answer
Player Last Name
*
Your answer
Year of Birth
*
2005
2006
2007
2008
2009
2010
Other:
What school will you attend in the fall of 2023
*
Kearney HS
Kearney Catholic HS
Columbus HS
North Platte HS
Grand Island SHS
GI Northwest HS
Hastings HS
Horizon MS
Sunrise MS
Other:
Fall 2023 Grade
*
Senior
Junior
Sophomore
Freshman
8th grade
7th Grade
Other:
Fall Sports & Activities
*
Cross Country
Golf
Softball
Volleyball
Other Activity
None
List Other Activity (from above question)
Your answer
Notes or comments on activities
Your answer
Player Cell Phone
Your answer
Player Email Address
Your answer
Mother First Name
Your answer
Mother Last Name
Your answer
Father First Name
Your answer
Father Last Name
Your answer
Mother Cell Phone
Your answer
Primary Email Address (where do you want all emails sent)
*
Your answer
Secondary Email - if needed.
Your answer
Father Cell Phone
Your answer
Emergency Contact Person
Your answer
Emergency Contact Cell Phone
Your answer
Medical Issues
Your answer
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