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Medical Form Registration Pay Online Attending Players

Paradise Soccer - No Day at the Beach, but Plenty of Fun!!

Please provide the following contact information: Please fill in the information then copy and paste into and email. Please send email to dise9@aol.com 

                                              Player

First Name
Last Name
 Current age
Date of Birth
Male /Female

Please provide the following contact information:

                                               Parent/Guardian

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Cell/Work Phone
Home Phone
E-mail

Select any of the following options that apply:

Camp 1 - June 22nd-25th (6pm-8pm)
Camp 2 - July 13th-16th  (9am-11am)
Tee Shirt ($10) - Sizes - YS - YL - Adult L

Please let me know in the email what size you would like!

 

 

 

 

Send mail to dise9@aol.com with questions or comments about this web site.
Last modified: May 21, 2009