Clone of REIGN FC SELECT REGISTRATION

REIGN DROPS & STORM FALL ACADEMY

FALL 2026 SEASON
Would you be interested in coaching?
PLAYER

First NameLast Name
PLAYER DATE OF BIRTH

MonthDayYear
Date
PLAYERS GENDER
PLAYER ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SCHOOL ATTENDING blanks
What soccer experience does your child have?
PARENT/GUARDIAN NAME

First NameLast Name
PARENT/GUARDIAN CELL PHONE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
PARENT/GUARDIAN EMAIL ADDRESS
example@example.com
PARENT/GUARDIAN #2 NAME

First NameLast Name
PARENT/GUARDIAN #2 CELL PHONE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
PARENT/GUARDIAN #2 EMAIL ADDRESS
example@example.com
PRIMARY EMERGENCY CONTACT

First NameLast Name
RELATIONSHIP TO PLAYER blanks
PRIMARY EMERGENCY CONTACT CELL PHONE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
Describe any allergies that we need to be made aware of.
Describe any medical conditions that we need to be made aware of.
UNIFORM SIZE
Once you have submitted your registration form, you will receive an informational email with program info, payment info & what to expect during the next few months within 1-3 days. If you have any questions please email us at admin@stclairshoresreignfc.com
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REIGN DROPS & STORM FALL ACADEMY