Delaware United FC General Soccer Registration Form

Delaware United FC

General Registration Form
Delaware United F.C. Registration:
This registration form is to be filled out if you were born in 2004-2015. As you progress with the application you will fill in "Child Information 1", if you are registering one child. If you are registering two children you will need to fill out information 1 and 2.

Training sessions:

Monday 6:00pm - 8:00pm

(De Turf Complex - Milford, DE)

Tuesday 6:30pm - 8:00pm

(Sand Hill Fields - Georgetown, DE)

Wednesday 6:30pm - 8:00pm

(Delaware United Training Center - Dagsboro, DE)

Thursday 6:30pm - 8:00pm

(Sand Hill Fields - Georgetown, DE)

Friday 6:00pm - 8:00pm

(De Turf Complex - Milford, DE)
CHOOSE LOCATION

Sand Hill Fields Georgetown, DEDE Turf Complex Milford, DE
CHILD INFORMATION # 1:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Male/Female*
CHILD INFORMATION # 2:
Child Name

First NameLast Name
Birth Date

MonthDayYear
Male/Female
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
UNIFORM INFORMATION Child 1
Youth Shirt
Youth Shorts
Adult Shirt
Adult Shorts
UNIFORM INFORMATION Child 2
Youth Shirt
Youth Shorts
Adult Shirt
Adult Shorts
MEDICAL INFORMATION Child 1
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical Concerns
MEDICAL INFORMATION Child 2
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical Concerns
Our Products
Parents and Guardians, Delaware United FC will be offering 40 training sessions to our athletes in our three month package. Out of the 40 total sessions 24 will be held on the field and 16 strength and conditioning sessions.
Payment
By submitting the form I, as the parent/guardian of the registrant, I herby give consent for emergency medical care prescribed by a dully licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of registrant.

By submitting the form, I the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the Delaware United FC, its affiliated organizations and sponsors. Recognizing the possibilty of physical injury associated with soccer and in consideration for Delaware United FC, accepting the registrant for its soccer program and activities (the "Program"). I hereby release, discharge and/or otherwise indemnify the Delaware United FC, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the programs, against any claimby or on behalf of the registrant as a result of the registrant's participation in the programs and/or being transported to or from the same, which transportation I hereby authorize.
Once you click Submit Form below, you will be taken to a secure PayPal site to complete your payment. Delaware United FC is a PayPal Verified merchant. You may pay by credit card or PayPal account.
My Products
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40 Sessions Package - 1 Children 3 Months (Quarterly)$675.00

40 Sessions Package - 2 Children 3 Months (Quarterly)$1,100.00

20 Sessions Package - 1 Children 3 Months (Quarterly) 2$370.00

20 Sessions Package - 2 Children 3 Months (Quarterly) 2$700.00

10 Sessions Package - 1 Children 3 Months (Quarterly) 4$200.00

10 Sessions Package - 2 Children 3 Months (Quarterly) 3$380.00

Total $0.00

Payment Methods

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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Delaware United FC

Delaware United F.C. Registration:

CHILD INFORMATION # 1:

CHILD INFORMATION # 2:

PARENT/GUARDIAN INFORMATION:

UNIFORM INFORMATION Child 1

UNIFORM INFORMATION Child 2

MEDICAL INFORMATION Child 1

MEDICAL INFORMATION Child 2

Our Products

Payment