Showcase Registration

Player's Name*
First Last
Parent/Guardian's Name*
First Last
Phone Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School
Year of Graduation
Height
Position
GPA
ACT/SAT/PSAT Score
Shirt Size
Roommate Request
Health Insurance Company
Policy Number
Coupon Code (Optional)
Date*
MM slash DD slash YYYY
Choose Payment Amount*
Event Details*
Payment Options*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00
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Midwest Boys Showcase Registration