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Registration form for Soccer Fun Night and Juniors night
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Indicates required field
Player Name
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First
Last
Male/Female
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Age
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Date of birth (mm/dd/yy)
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Grade Level Fall '15
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Street Address
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City
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Zip
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Parent(s) Name
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Address(if different)
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Zip
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Home Phone Number
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Cell or 2nd Phone Number
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Email
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What dates are you registering for?
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Soccer Fun Night October 1
Juniors Night October 8
Comments or questions?
*
Please indicate if there are multiple children you are registering for and their names.
Submit