1. Sign Up

Class Information

Location: DuPont : Clocktower Park Day: Friday Class: Soccer 1 (5 - 6 yrs) Time: 4:05-4:50pm Dates: 9/13/19 — 10/25/19 Meetings: 6 Class Price: $79.00

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.