2018 July 22 C-BC Network Exposure Scrimmage Night Contact Form

Download forms for Exposure scrimmage
(3 forms needed to download and complete for registration)

Lead Clinicians:
Molly Alvey, Head Coach
University of Cincinnati

C-BCNEC Director: Ruth N. Nelson (www.lvclub.org)

* Indicates required field

Player Name *

First

Last

Player Email *

Player Phone Number *

Give me some background about you that will assist us in understanding what your goals are for college and playing! *

What do you expect from this exposure scrimmage session? *

Will you be paying session with? *

All payments MUST be upfront for program checks payable to brvc

Parent Name *

First

Last

Parent Email *

Parent Phone Number *

Graduation Date *

Club Name and Level *

High School , Grade *

Click the one that applies (present grade/ club level *

Select the grade that applies *

Please Select Primary Position in High School *

Please Select Primary Position in Club *

T-shirt Size *

If you would be interested in our regular Sunday Night Scrimmage Program *

I agree to receiving marketing and promotional materials

Submit