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["TEAM:",{"$nulls":26},"VERSUS:",{"$nulls":29},"GAME #"]
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["TEAM REP (PRESENT):",{"$nulls":26},"GYM:",{"$nulls":29},"DATE:"]
[{"$nulls":7},"PLEASE PRINT CLEARLY"]
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[{"$nulls":3},"REFEREE'S SIGNATURE"]
[{"$nulls":53},"OPPONENT'S SCORE"]
[{"$nulls":29},"COACH'S SIGNATURE:"]
[{"$nulls":3},"REFEREE'S SIGNATURE"]
[{"$nulls":13},"TEAM EVALUATION:  (ADDITIONAL COMMENTS MAY BE PLACED ON THE BACK OF THIS SHEET)"]
["GYM MONITOR:",{"$nulls":18},"POOR      FAIR       GOOD",{"$nulls":9},"SCOREKEEPER:",{"$nulls":23},"POOR      FAIR        GOOD"]
[{"$nulls":5},"(PLEASE PRINT OR SIGN SO IT CAN BE READ EASILY)",{"$nulls":31},"(PLEASE PRINT OR SIGN SO IT CAN BE READ EASILY)"]