Soccer Summer Camp
Registration
Parent's Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
How many children are you registering?
One
Two
Three
Player's name
*
First Name
Last Name
Sex
Male
Female
Date of Birth
*
-
Day
-
Month
Year
Date
Confirm Age
*
Second Player
First Name
Last Name
Second Player's Sex
Male
Female
Second Player's Date of birth
-
Day
-
Month
Year
Date
Confirm Age
*
Third Player's Name
First Name
Last Name
Third Player's Sex
Male
Female
Third Player's Date of Birth
-
Day
-
Month
Year
Date
Confirm Age
*
Do you give our staff permission to take photos for our social media and website ?
*
Yes
No
Which Session are you wanting to do for Summer Camp?
*
Tuesday 14th January ($50) 10am-12pm
Wednesday 15th January ($50) 10am - 12pm
Both ($80)
Payment Option
Cash on the day
Eftpos on the day
Bank Transfer
Save
Submit
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