Spring Registration Form (New Players)

Prodigy Soccer Academy Registration
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
Gender*

MaleFemale
Jersey Size*
Parent/Guardian Information
Name*

First NameLast Name
Home Number

Area CodePhone Number
Cell Number*

Area CodePhone Number
E-mail*
Preferred Language*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How did you hear about us?*
If other, type here:
Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
PLAYER CONTRACT
PLAYER CONTRACT AGREEMENT (ENGLISH)
CONTRATO DE JUGADOR (ESPAÑOL)
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Payment Information
Paying in cash?*
If yes, Please contact us via email or text message. prodigysocceracademy1503@gmail.com (561) 412-8492

My Subscriptions

U-3 to U6($75.00 for each month)

U7-U10($80.00 for each month)

U11-U17($85.00 for each month)

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Prodigy Soccer Academy Registration