Elite Soccer Training in Raleigh

PB Academy Parent Info

Parent First Name *

Parent Last Name *

Parent Phone Number *

Parent Email *

PB Academy Player Info

Player First Name *

Player Last Name *

Player Date of Birth *

Ex. 01/01/2006

Player Email *

Player Phone Number *

Player Instagram *

If you don't have one, type "none"

Player Field Position *

Current Player Club *

If you currently don't play club, type "none"

Player Height (ft) *

Player Weight (lbs) *

Extra Player Interest Info

Interested in 1 on 1, elite pickup, recruiting, etc.

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