Souled Out Summer Registration Form

Souled Out Summer Registration Form

Please fill out the information on this form.
Student Name:*

First NameLast Name
Student Cell Number: (if applicable)
Please enter a valid phone number.
Grade Completed*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
T-Shirt Size*

SMLXL2XL3XL4XL
Parent(s) Name*

First NameLast Name
Parent Cell #1:*
Relationship to Student*
Emergency Contact Information
Emergency Contact Name:

First NameLast Name
Phone:
Relationship to Student:*
The $50 deposit is due by Sunday, March 17th. By paying this amount of $50 you are committing to pay the remaining balance of $325. All fees are non-refundable. We understand that things happen, and if anything happens to where your student is unable to go please contact Tony or Todd.

*There will be 2 fundraisers to help cover the cost. Information will be sent out closer to the start of the fundraiser*
By signing this form, you are acknowledging that these fees are not refundable except under specific conditions listed and you are agreeing to pay the full amount of $375 ($325 after deposit)
Signature of Parent/Guardian:
Date*

MonthDayYear
Date
Should be Empty:

Emergency Contact Information