Registration

Registration & Online Payment

SPRING TRAVEL REGISTRATION $150 with additional fee for Uniform

INSTRUCTIONAL SOCCER $75 with additional fee for Uniform

2010 Registration (All Fields Are Required)

	Child's Name *

	Specify if Registering for Spring Travel Team or Instructional

	Date of Birth

	Home Address

	E-mail address

	Parent's/Guardian's Name

	Home phone

	Cell phone

	Emergency Contact's Name

	Emergency contact#

	Local Parish in Your Area

	Allergies/Medical Conditions

OUR LADY of GRACE SOCCER