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soccer for usa registration
soccer for usa registration
soccer for usa registration
 

 

Soccer Clinics

for Pre-School and Elementary Soccer Players

soccer for usa

When:

Session #1     (Feb. 2, 9, 16, 23) Saturday’s
Session#2     (March 2, 9, 16, 23) Saturday’s

Times:

9:00    - 9:45 am     3-4 yrs
10:00 - 10:45 am     5-6 yrs.
11:00- 11:45 am    7-8 yrs.

Where:

Living Word Bible Church (lawn area/soccer fields)
3520 East Brown Road, Mesa 85213

Reason:

To Learn and have Fun with your Soccer game!

Cost:

$55 (if registered 2 weeks prior to camp/clinic)
$60 (if not registered 2 weeks prior to camp/clinic)

Bring:

Soccer ball, shin guards, tennis shoes, water and great attitude

Director Information:
Scott Holt has an elementary teaching credential and national coaching license.  He has coached 3 year olds, elementary, Jr. High, High School and the College level, boys and girls and men and women alike.

Scott Holt spent over 10 years of his youth traveling around the world playing soccer for the state, western regional and national champion soccer team, the NHB Untouchables.  He went on to receive a soccer scholarship at Westmont College and was a starter for the final four national finalists.

Coach Scott Holt, Director – cell 480-788-0259

e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Soccer USA Registration Form

www.soccerforusa.com

Complete this form and send it along with your check of $60
or  (if paid 2 weeks prior to session)  $55
Please make check payable to Soccer USA and send to:
315 W. Elliot Rd, Suite 107-304, Tempe AZ 85284

Amount Enclosed: *

Please enter amount.

How did you hear about us?:

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Player Information
Player Name: *

Please enter your name.

Age: *

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Gender: *

Please select your gender


Session Attending:

Session #1:

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Time:

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Session #2:

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Time:

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Address: *

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Email address: *

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Phone numbers:
Home:

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Business:

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School player attends:

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Grade next fall:

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Insurance Information

Holder’s name:

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Company:

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Medical Information

Emergency Contact Person:

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Phone number:

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Current medications:

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Medical limitations:

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Please Read and Sign


I hereby authorize the director and staff of Soccer USA to act for me according to their best judgment in any situation requiring medical attention for my child/minor. I hereby release, exonerate and discharge reddingkids.com. My son/daughter is healthy and capable of participating in this sports clinic. I will be responsible for any medical charges incurred and agree to the conditions of this agreement.

Parent Signature: *

Please enter parent name in Capital Letters




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