Parent-Led Soccer Clinic Registration

There are no on-site bathrooms available at Hester School

Please be sure to bring water, and cleats + shin guards if you have them (not required)

***Note that this clinic is parent-organized, parent-led, and parent-funded***

***St. Clare School is not responsible for any accidents or injuries that may occur***

Child Name

First Name

Last Name

Grade

Soccer playing experience?

Never

With friends, not organized

With a recreational or school team

With a competitive or travel team

Parent / Guardian E-mail

Parent / Guardian Phone

(###)

###

####

Child Medical Plan Name

Child Medical Plan Policy Number

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Any additional message? Ready to coach, or be a team parent?