Middle School Soccer Academy Sign Up Form Athlete's Name * First Name Last Name Athlete's Age * Athlete's Grade * Athletes Date of Birth * MM DD YYYY Middle School Attending * Parent's Name * First Name Last Name Parent's Email * Parent's Cell Phone * (###) ### #### Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How Did You Hear About Us? * By Signing Up For this Program, Purchaser Acknowledges and Accepts the Following: * All sales are final All sessions are non-transferable, non-refundable, are only valid for the days and times specified in this program, and expire at the conclusion of this program A wavier is required in order to participate in this program Thank you for signing up for our Middle School Soccer Academy. Please note, your reservation is not complete until payment has been received. If you have any questions, please contact Jeremy at jeremy@lpcsoccer.com. We look forward to working with your child this summer!
