Name:
*
First Name
Last Name
Email:
*
Phone Number:
*
How many children are you looking to register?
*
Please Select
1
2
3 or More
(This information helps us provide accurate pricing options based on your needs.)
Please provide the age(s) and/or preferred class type(s) for each child you’re looking to register.
*
(This helps us suggest the best class options for your family.)
How did you hear about our Scholarship Program?
*
Select a Lil' Kickers Location:
*
Germantown
Glendale
Lombard
McCook
Morton Grove
New Berlin
Northbrook (Outdoor)
Oak Park
Roscoe Village - Bradley Place
Park Ridge (Outdoor)
Roselle/Schaumburg
West Loop - Lake Street
Waveland (Outdoor)
West Dundee/Elgin
Wicker Park (Outdoor)
Vernon Hills
Any Additional Comments:
Please submit any relevant documents.
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