Blessed Sacrament School 2017/18 Soccer Session II Registration Form
Please answer the following questions for each student who will be playing soccer. (Click "Submit another response" at the end of each child's submission). Complete by Friday, January 19. Soccer Session II begins the week of January 22.
Email address *
Child's Last Name *
Your answer
Child's First Name *
Your answer
Street Address *
Your answer
Town *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Parent 1 Name *
Your answer
Parent 1 cell phone *
Your answer
Parent 1 email address *
Your answer
Parent 2 Name
Your answer
Parent 2 cell phone
Your answer
Parent 2 email address
Your answer
Additional Emergency Contact (other than parent) *
Your answer
Emergency contact phone number *
Your answer
Homeroom *
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