Soccer Registration Form

Hanlin Soccer Class Registration
You will need to fill out one registration per child. Once you have completed the regsitration, we will send you an invoice and you can pay online. A confirmation email will be send out once you finished registration and payment.

Session : April 23-June 11 Saturday Morning

Age: Group 1 3:00-4:00pm Age 5-6

Group 2 4:00-5:30pm Age 7 Up

Address: Central Elementary School 525 Middle Rd, Belmont

Each session will have a minimum of 8 students, maximum 15 kids to make the best experience possible.
I would like to enroll

Group 1 (Age 5-6) 3:00-4:00pm $150Group 2 (Age 7 up) 4:00-5:30pm $225
CHILD INFORMATION:
Child Name*

First Name Last Name
Birth Date*

Month Day Year
Male/Female*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number*

Area Code Phone Number
E-mail*
UNIFORM INFORMATION
Youth Shirt
Youth Shorts
Adult Shirt
Adult Shorts
MEDICAL INFORMATION
Physician Name

First Name Last Name
Phone Number

Area Code Phone Number
Medical Concerns
By submitting the form, I, as the parent/guardian of the registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may 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 BYSO, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the Hanlin, accepting the registrant for its soccer programs and activities (the "Programs"). I hereby release, discharge and/or otherwise indemnify the Hanlin, 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.
Should be Empty:

Hanlin Soccer Class Registration

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION:

UNIFORM INFORMATION

MEDICAL INFORMATION