Player Registration Form

Contact Information

First Name

Last Name

Confirm Email

Mobile Phone

Address Line 1

Address Line 2

City

State:

Zip

Preferred mode of contact:

Player Information Sex:

Position Played:
Yes, I am a starter:

Season Highs

Pts

Rebs

Assts

Physical Feet: Inches

Weight (lbs)

Shirt Size (adult):

Dribbling

Right Handed

Left Handed

Academics Classification:

GPA

SAT

ACT

Miscellaneous

Yes, I am interested in receiving additional services from Get A.M.P.ed! Inc.:

Describe services here
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