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iM3 Lacrosse Evaluations

Player Information

Graduation Year *

Player Birthdate *

Last Name *

First Name *

U.S. Lacrosse Number (if applicable)

Position *

Attack

Midfield

Defense

Goalie

School District *

Street Address *

City *

Zip Code *

Phone Number *

Mother Name *

Mother Cell Phone Number *

Mother Email *

Father Name *

Father Cell Phone Number *

Father Email *

Attending Saturday, August 19 *

Attending Saturday, August 26 *

Player Registration Fee - $25.00 *

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