subject_line
Soccer Blast
TURF TOTS
Player Information
Player Information
Player's First Name
*
Player's Last Name
*
Birth Date
*
+
Age:
*
3 Years Old
4 Years Old
5 Years Old
T-Shirt Size
*
Youth 2/4 (XS)
Youth 6/8 (S)
Youth 10/12 (M)
Youth 14/16 (L)
Adult Small
Other
Other
Parent First Name
*
Parent Last Name
*
Address 1
*
Address 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip
*
Phone
*
Email Address
*
Second Email Address/Second parent
Session/Dates/Fees
Select Day:
*
Thursdays
Saturdays
Thursday Sessions (6:00 PM):
Winter I - Oct 21, 28, Nov 4, 11, 18, Dec 2, 9, 16 - $95
Winter II - Jan 6, 13, 20, 27, Feb 3, 10, 17, 24 - $95
Winter III - Mar 3, 10, 17, 24, 31, April 7, 14, 21 - $95
Saturday - Sessions:
Winter I - Oct 30, Nov 6, 13, 20, 27, Dec 4, 11, 18 - $95
Winter II - Jan 8, 15, 22, 29, Feb 5, 12, 19, 26 - $95
Winter III - Mar 5, 12, 19, 26, April 2, 9, 16, 23 - $95
Saturday Time:
*
10:00AM - 11:00AM
11:00AM - 12:00PM
You are eligible to Save $$ by registering for 3 sessions.
Enter Code "Save30" to save $30!!
Must enter at this time to save!
You are eligible to Save $$ by registering for 3 sessions.
Enter Code "Save30" to save $30!!
Must enter at this time to save!
Paying by Check or Credit Card?
*
Credit Card (3% Credit Card Fee will be added)
Check (to be mailed in - No Service Fee)