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Age 4-5 Registration - Fall 2021
Age 4-5
Tuesdays, September 7-October 12 (If needed, make up class to be held on October 19)
4:00-4:45 pm

Willow Haven Park
2375 W 300 N, Lehi, UT 84043

Cost: $45 Pay Cash, Check made out to Melanie Henage or Venmo @melanie-henage
Participants will need to bring their own ball (size 3)
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Participant's first name *
Last name: *
Age (As of September 1, 2021): *
Gender: *
Required
Parent or Guardian name: *
Phone number: *
Email Address: *
Emergency Contact: *
Emergency contact's phone number: *
List any medical conditions or other needs, if any, that we need to be aware of:
We sometimes have parents who want to be more involved during class. If you are interested in being a "team manager," check one of the boxes below. Possible duties include: being available during class to help the coach with equipment or gathering kids when needed. There is no pressure to volunteer- we just wanted to give those parents who want to be more involved an opportunity! Thanks!
I hereby give my consent for the named participant to participate in this Kid Star Soccer class and for the staff to secure emergency medical services in case of injury. Kid Star Soccer and the staff are not liable for any injuries or loss of equipment. I grant permission to the staff to authorize and obtain medical care for the participant in case of an emergency. I also grant permission for photographs and videos to be taken of the named participant to be used for the promotion of Kid Star Soccer. I agree to receive emails from Kid Star Soccer and know I can ask to be removed from the mailing list at any time. *
Required
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