Kid's Club Registration
Child's First Name:
Child's Last Name:
Age: CHOOSE ONE 3 4 5
Date of Birth: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2000 2001 2002 2003 2004 2005 2006
Parent's Name:
Phone:
Address:
City:
State:
Zip:
Email:
Tuesday Classes 4pm I Sept. 16 - Oct. 21 II Nov. 4 - Dec. 9 III Jan. 6 - Feb 10 IV Feb 24 - March 31 V TBA
Session: I II III IV V
Day: Choose One Tuesday Thursday
Questions Email SoccerCitySC@yahoo.com
OR CALL: (413)543-8554)
Signature: