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Mississippi Brilla 2012 Tryout Registration
Please complete each field. When we have received your registration form and payment, we will send email confirmation that you are registered for the tryout.
Name
*
Email
*
Phone
*
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Current or Former School
Position(s)
Have you played in the Premier Development League before?
Yes
No
If yes, for what team(s) and when did you play?
Have you received any special recognition in your soccer career?
(All-American teams, awards, honors, etc)
Payment
I have paid or will pay online via PayPal.
I am mailing a check to Brilla Office.
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