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| Team Information |
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| Team Name |
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| Region # |
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Girls ____ |
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| Color of jersey |
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Boys
____ |
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| Color of shorts |
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| Color of socks |
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| Coach
Information |
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| Coach's name |
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Email |
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| Address |
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| City |
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State |
Zip code |
| Home Phone |
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Cell Phone |
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| Contact
Person |
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Email |
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Phone |
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| I
certify that this coach is a registered volunteer with AYSO |
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| AYSO
REGIONAL COMMISSIONER |
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| This
form and the registration fee of $100 must be received by July 14 2010. |
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| Mail to: |
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| AYSO
High Valley Shootout |
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| P.O. Box 614 |
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| Eden, UT 84310 |
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