Bryan Girls & Boys Soccer Clinic Registration 2026
Grades 4th-7th Grade
Personal Details
Name
*
First Name
Last Name
Gender
*
Male
Female
Date of Birth
*
Please select a day
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Day
Please select a month
January
February
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December
Month
Please select a year
2016
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Year
Cellphone Number
-
Area Code
Phone Number
Contact E-mail
*
Shirt Size
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Grade
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
Emergency Contact Details
Name of Emergency Contact
*
Must be available 24 hours a day during the camp
Relationship to you
*
Phone Number
-
Area Code
Phone Number
Cell Phone
*
Medical Details
Specify any conditions that may effect you during camp and require special care:
Medical conditions
Medication - Specify any medication that you may be taking during camp:
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