Omega Select Registration Form


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Please submit the following information to be invited on a select team:

*Player's Full Name :
*Parent Full Name :

*Email :

Citizenship:

Country of Ancestry :
Address :
City :
State/Prov :
Postal Code :
Home Phone :
Cell Phone :
Date of Birth :
Register for Team :
Graduation Year:
Current Club Team :

High School Team:

Positions:

Uniform Size:

Comments /

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