subject_line
Soccer Blast
TURF TOTS
Registration Form
Player Information
Player Information
Player's First Name
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Player's Last Name
*
Birth Date
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Age:
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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
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Address 2
City
*
State
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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
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Phone
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Email Address
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Second Email Address/Second parent
Session/Dates/Fees
Select ALL sessions registering for.
$30 discount if registering for all 3 sessions.
Select Day/Time:
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Thursdays - 6:00PM
Saturdays - 10:00AM
Saturdays - 11:00AM (Closed WII)
Thursday session (6:00 PM):
Winter I - Oct 27, Nov 3, 10, 17, Dec 1, 8, 15, 22 - $95
Thursday session (6:00 PM):
Winter II - Jan 6, 13, 20, 27, Feb 3, 10, 17, 24 - $95
Thursday session (6:00 PM):
Winter III - Mar 2, 9, 16, 23, 30 Apr 6, 13, 20 - $95
Saturday Sessions (10:00 AM):
Winter I - Oct 29, Nov 5, 12, 19, 26 Dec 3, 10, 17 - $95
Saturday Sessions (10:00 AM):
Winter II - Jan 7, 14, 21, 28, Feb 4, 11, 18, 25 - $95
Saturday Sessions (10:00 AM):
Winter III - Mar 4, 11, 18, 25, Apr 1, 8, 15, 22 - $95
Saturday Sessions (11:00 AM):
Winter I - Oct 29, Nov 5, 12, 19, 26 Dec 3, 10, 17 - $95
Saturday Sessions (11:00 AM):
Winter III - Mar 4, 11, 18, 25, Apr 1, 8, 15, 22 - $95
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!
You are eligible to Save $$ by registering for 3 sessions.
Enter Code "Save30" to save $30!!
Must enter at this time to save!
This is to certify that I, as parent/guardian with legal responsibility for this child do consent and agree to release Soccer Blast, its officers, employees, volunteers, officials and agents from any and all claims, liabilities, loss of service and causes of action of any kind for personal injury and property damage arising out of my child’s involvement or participation in this program
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Date
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