Top of The Bay Laxin’ Out Loud 2017 Step 1 of 5 20% Choose Your PackageFields with an asterisk (*) are required.Are you purchasing as an Individual, or for the Team?*Select OptionIndividualTeamChoose your interest.*Choose from purchasing game film only, or from having a highlight reel produced. Learn more about our highlight reel options by selecting the option.Select OptionFilm OnlyFilm and Highlight ReelChoose your Individual Film package.*Select OptionSingle Game FilmChoose your Team Film package.*Select OptionFull Team Access - All Game FilmChoose your Individual Highlight package.***Custom** - Submit this form and we will send you the game film and a Time Stamps form. Send us back the form with the times of the clips you would like and we will get to work! **Professional** - Submit this form and we will have our Professionals take care of all the work!Select OptionCustom PackageProfessional PackageChoose your Team Highlights package.*Select OptionFull Team Highlights - All Game FilmNumber of Teams*Select Option12Post-Event Team Access - 1 Team* Price: $ 549.00 Post-Event Team Access - 2 Teams* Price: $ 999.00 Post-Event Team Highlight - 1 Team* Price: $ 649.00 Post-Event Team Highlight - 2 Teams* Price: $ 1,199.00 Post-Event Single Game Film* Price: $ 79.00 Post-Event Custom Highlight Reel* Price: $ 125.00 Post-Event Professional Highlight Reel* Price: $ 175.00 Coupon Total $ 0.00 Package DetailsFields with an asterisk (*) are required.Team Name*Division*Select Option201820192020202120222023202420252026Time of Game and Opponent*Team Name 2*Division - 2nd Team*Select Option201820192020202120222023202420252026 Customer InformationFields with an asterisk (*) are required.Team Location*Where is your team from?Team Record From EventWas the team Division Champions?Select OptionYesNoCorrespondence Email*Please provide the email address with which we will correspond. Enter Email Confirm Email Contact Phone Number*Please provide a phone number to contact you at.Team EmailsIf you'd like us to send the game links to your team, please provide an excel spreadsheet with their email addresses in Column A.Accepted file types: xls, xlsm, xlsx.Head Coach Name First Last Head Coach Phone NumberPlease provide a phone number to contact you at.Head Coach Email Enter Email Confirm Email Assistant Coach Name First Last Assistant Coach Phone NumberPlease provide a phone number to contact you at.Assistant Coach Email Enter Email Confirm Email I would like to receive information about CruitCast products and services.*Select OptionYesNo Player InformationFields with an asterisk (*) are required.This section is only for Individual Highlight Reels. Please click Next to Continue. Athlete's Name* First Last Jersey Number*High SchoolHigh School CityHigh School StateGraduation YearSelect Option2017201820192020202120222023202420252026Primary PositionSelect OptionAttackDefenseFaceoffGoalieLSMMidfieldSecondary PositionSelect OptionAttackDefenseFaceoffGoalieLSMMidfieldHeightSelect Option4'4'14'24'34'44'54'64'74'84'94'104'115'5'15'25'35'45'55'65'75'85'95'105'116'6'16'26'36'46'56'66'76'86'96'106'117'7'17'27'37'47'57'6Weight (lbs.)Facebook HandleInstagram HandleLinkedIn HandleSnapChat HandleTwitter HandleAccoladesFields with an asterisk (*) are required.GPASAT Total Combined ScoreACT Total Combined ScoreOther Academic AccoladesHave you been on the Honor Roll? Have you received any awards, or merits? College coaches want to know this!Athletic AccoladesLet coaches know what teams you have played for, if you were a captain, if you won any awards, or any other athletic information!Contact InformationThis information will be used in the second part of the introduction of the highlight reel for college coaches to contact the player. Fields with an asterisk (*) are required.Player Contact Email Enter Email Confirm Email Player Contact Phone NumberHigh School Coach Name First Last High School Coach Email Enter Email Confirm Email High School Coach Phone NumberClub Coach Name First Last Club Coach Email Enter Email Confirm Email Club Coach Phone Number Billing InformationFields with an asterisk (*) are required.Your Total is: $ 0.00 Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Verify Cardholder's Name* First Last