Bulldog Soccer Clinic

Bulldog Soccer Clinic

Complete the form below to sign up for the Bulldog Girls Soccer Clinic on Sunday, October 16th, 2022 from 2pm to 4pm at Churchill High School.
Birth Date:*

MonthDayYear
Player's Name*

FirstLast
Mother's Name*

PrefixFirst NameMiddle NameLast NameSuffix
Mother's Phone Number:*

Phone Number
Mother's E-mail*
Father's Name*

First NameLast Name
Father's Phone Number:*

Phone Number
Father's E-mail*
Address:*

Street Address

Street Address Line 2

CityState / Province

Post CodeCountry
Player's Grade:*
Field Address:

Winston Churchill High School, 11300 Gainsborough Road, Potomac, MD
Permission & Liability Waiver:

I give permission for my child to attend the Bulldog Soccer Clinic on September 10th. I know that there are some risks associated with playing soccer, as with any sport. I understand that MCPS, the Churchill Administration, Coaches, Players and volunteers are not liable for any injuries that occur while my child is attending the soccer clinic.
Important:*

I have read, understood, and accepted the Permission & LIability Waiver used by Bulldog Soccer.
Please pay $40 via paypal at:

paypal.me/GirlsSoccerFundraise

or send a check payable to "Churchill Booster Club" to:

Churchill Booster Club

11300 Gainsborough Road

Potomac, MD 20854

Attn: Sandy Max
Should be Empty:

Field Address: