Hillside Chapel / Registration Forms / Co-ed Soccer Clinic

Register for our event by filling out the information below:

Last Name

First Name

Gender

Age

Grade

Date of Birth (mm/dd/yr)

Please enter your full address:

Street Address

City

State

Zip Code

Cell or Daytime Phone Number (xxx-xxx-xxxx)

Parent/Guardian Name (First & Last Name)

Emergency Contact Name (First & Last Name)

Emergency Contact Number (xxx-xxx-xxxx)

Emergency Contact Relationship to Child

Medical Issues Including Allergies if Pertinent

How did you hear about camp?

Email Address

T-Shirt Size Alternative Sizing in Parentheses ()

YXS (size 2-4)

YS (size 6-8)

YM (size 10-12)

YL (size 14-16)

AS (34-36 Chest Size)

AM (38-40 Chest Size)

AL (42-44 Chest Size)

AXL (46-48 Chest Size)

T-shirt aren't guaranteed for registrations submitted after April 2.

As parent or guardian, I give permission for my child to participate in all activities, for treatment if needed by a licensed physician due to accident or injury, and for the use of photos by Hillside Chapel for promotional use...

Yes

No

Please note that filling out this form is only part of the registration process. Cash or check made out to Hillside Chapel is due the day of registration. Cost is $7/child.

Parent/guardian will be asked to fill out a full liability waiver on the day of the soccer clinic, April 15.

Event Registration