Kid Registration

1. SPRING 2012 SOCCER (From Age 5 to Age 13)
2. Child #1 Name:(required)
3. Birth Date:
4. Age:(required)
5. Gender:
6. Male Female
7. Child #2 Name:
8. Birth Date:
9. Age:
10. Gender:
11. Male Female
12. PARENTS/GUARDIANS INFORMATION
13. Parent #1Name: (required)
14. Parent #2 Name: (required)
15. Address:(required)
16. Email Address(valid email required)
17. Home Phone #
18. Mobile #(required)

 

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