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Class Information

Location: DuPont : Clocktower Park Day: Friday Class: Soccer 1 (5 - 6 yrs) Time: 4:20-5:05pm Dates: 6/21/19 — 7/19/19 Meetings: 4 Class Price: $57.00

Student Information

*First Name:

Last Name:

Date of Birth: (mm/dd/yy)

Parent/Guardian Contact Information

First Name: Address/P.O.Box: City:

Last Name: Suite or Apt.: (optional)

State: ZIP/Postal Code: Country: Email Address:

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