Achievement Award Application

To receive Urban Xtreme Achievement Awards for your club, complete the application below and we will be in contact soon *Required

Club Name*
Type of Sport*
Postal Address*
Line 1 Line 2 City State / Province / Region ZIP / Postal Code
Number of Junior Teams Requiring Awards (>13)*
Number of Senior Teams Requiring Awards (<14)*
Total Number of Players at Club (approx)*
Season Start Date*

DD
MM
YYYY
Number of Weeks in Season*
Additional Information*
Any other information you would like to share about your club - include advertising & sponsorship opportunities, fundraising or other events that Urban Xtreme may be interested in supporting
Contact #1*
Name Role
Contact #1*
Phone Email Preferred Contact Method & Time
Contact #2
Name Role
Contact #2
Phone Email Preferred Contact Method & Time
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