Full Name *

Date of Birth *

Email *

Phone *

State * Select State ABIA ABUJA ADAMAWA AKWA IBOM ANAMBRA BAUCHI BAYELSA BENUE BORNO CROSS RIVER DELTA EBONYI EDO EKITI ENUGU GOMBE IMO JIGAWA KADUNA KANO KATSINA KEBBI KOGI KWARA LAGOS NASARAWA NIGER OGUN ONDO OSUN OYO PLATEAU RIVERS SOKOTO TARABA YOBE ZAMFARA

LGA * Select LGA

Jersey Number *

Position * Select Position Goalkeeper Defender Midfielder Striker Winger

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