JJ Soccer Clinic
JJ Soccer Clinic Flyer
Email address *
Parents Name *
Childs Name *
Are you going to order a T-Shirt *
What grade is your child in ? *
Does your child have any allergies ? *
If so what are they ? *
Medical insurance information *
Emergency contact information
Name & Relationship *
Home Phone Number *
Cell Number *
Do you give staff permission to do first aid *
Is there anything else the clinic staff needs to know about your child ? *
A copy of your responses will be emailed to the address you provided.
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