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Player's first name
*
Player's last name
*
Birthday
*
Month
Day
Year
Age on August 1st, 2026
*
Grade entering fall 2026
*
Gender
*
Has your player previously played for FC Galesburg
*
Yes
No
Guardian's first and last name
*
Phone
*
Email
*
Guardian 2 first and last name
Guardian 2 Phone
Guardian 2 Email
EARLY BIRD DISCOUNT - use code FCGFALL for $25 off
$125
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