Soccer Registration Form

Boys and Girls Soccer Registration

All boys and girls in grades 5-8 in the Sevastopol and Gibraltar School Districts are invited to join our Mighty Pioneer soccer team! Teams will get schedules and communication from Mighty Pioneers and coaches by connecting to the team HEJA page. That code will be on the registration confirmation after registering.
Athlete Information
Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
2026/2027 Grade
Parent/Guardian Information
Name

First NameLast Name
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Additional Parent/Guardian Contact
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Emergency Contact ((non-parent): Provide name and number in case we cannot reach a parent contact in an emergency situation. (non-parent):
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Mighty Pioneer Waiver
Updated Code of Conduct
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature
My Products
prevnext( X )
Fall Soccer Registration
$65.00 Quantity

Total

$0.00

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Boys and Girls Soccer Registration