Soccer Camp Registration Form
Fill out the form carefully for registration
Player Name
*
First Name
Middle Name
Last Name
Player Date of Birth
*
-
Month
-
Day
Year
Date
Player Gender
*
Please Select
Boy
Girl
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent or Guardian Name
*
First Name
Last Name
Parent E-mail
*
example@example.com
Parent Mobile Number
*
Any Allergies?
Type of Registration
*
Residential - $350
Non-Residential - $200
Payment
If you have decided your type of registration, use the information on the next page to make your payment. If you have more than one player, please make payment per player.
Submit
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