Participant Soccer Coaching Classes

Name of Parent/Guardian*

First Name of Parent/GuardianLast Name of Parent/Guardian
Phone Number*
E-mail*
example@example.com
Name of Participant*

First Name of ParticipantLast Name of Participant
Age of Participant*
Participant may be photographed/video graphed during the Soccer Classes at India House and these pictures/videos may be used on India House website/social media for outreach purposes.
Signature*
Should be Empty: