Registration

Registration & Online Payment

SUMMER CAMP $75

FALL 2010 TRAVEL REGISTRATION $150

INSTRUCTIONAL SOCCER $75

OUR LADY OF GRACE UNIFORM $50

2010 Registration (All Fields Are Required)

	Child's Name *

	Specify if Registering for Summer Camp, Fall 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