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Welcome to the DMS11 Registration Form
Please fill out the form below, required information is marked by *.
If you have multiple Players you will need to fill this form out for each Player. You may use the same contact information.
Please select the check box that best describes your affiliation with DMS11. For example, if you are a team member and have participated in our Academy and SAQ
training, you should check all three boxes. Another example might be an academy member and a prospect.
We will use this information to send you DMS11 event updates,
which pertain to your specific affiliation based on what you select.
*DMS11 Affiliation
Team Member
SAQ
Academy
Movie Academy
Private Sessions
I am a Prospect
Formally was affiliated with DMS
*Player'S Details
First Name
Last Name
Height
Please choose
4' 0
4' 1
4' 2
4' 3
4' 4
4' 5
4' 6
4' 7
4' 8
4' 9
4' 10
4' 11
5' 0
5' 1
5' 2
5' 3
5' 4
5' 5
5' 6
5' 7
5' 8
5' 9
5' 10
5' 11
6' 0
6' 1
6' 2
6' 3
6' 4
6' 5
Sex
Please choose
Male
Female
Birthday
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Years Playing
Please choose
1
2
3
4
5
6
7
8
9
10
Best Foot
Please choose
Right
Left
Position
Please choose
Goalie
Center Back
Right Back
Left Back
Right Middle
Center Middle
Left Middle
Center Front
Right Center
Left Center
Striker
Sweeper
(Current Season) Division
Please choose
Boys U6
Boys U7
Boys U8
Boys U9
Boys U10
Boys U11
Boys U12
Boys U13
Boys U14
Boys U15
Boys U16
Boys U17
Boys U18
-
Girls U6
Girls U7
Girls U8
Girls U9
Girls U10
Girls U11
Girls U12
Girls U13
Girls U14
Girls U15
Girls U16
Girls U17
Girls U18
Bracket
Please choose
National Team
Olympic Program
Professional
Semi Professional
College
Premier
Academy
Gold
Silver Elite
Silver
Bronze
AYSO/Recreational
Team
Current Team
Division Bracket Team
Primary Contact Information
*Name
*Email
Home Phone
Work Phone
Cell Phone
*Primary Residence
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-
Not Applicable
Zip
Country
Mother's Information
Name
Home Phone
Work Phone
Work Fax
Cell Phone
Email
FATHER'S INORMATION
Name
Home Phone
Work Phone
Work Fax
Cell Phone
Email
*Login Information
Username
Username is the Primary Contact Email
(Min. 4 Characters) Password
We will not sell, distribute or lease your personal information to third parties.
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