1. Sign Up

Class Information

Location: Lodi : Vinewood Elementary School Field Day: Monday Class: Soccer 1 (5 - 6 yrs) Time: 4:15-5:00pm Dates: 9/9/19 — 10/28/19 Meetings: 8 Class Price: $82.00

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:

Phone #1:

ext.

Phone #2: (optional)

ext.