Registration | Lakeshore Youth Socc

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123-456-7890

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Player First name*

Player Last name*

Birthday*

Month

Day

Year

Gender

Male

Female

Prefer not to answer

File upload

Parent/Guardian Name*

Phone*

Parent/Guardian Email*

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Team*

U4 (2022)

U6 (2020-2021)

U8 (2018-2019)

U10 (2016-2017)

U13 (2013,2014,2015)

Are you Interested in Volunteering? If yes, Please fill out the Volunteer Form (found on the Home Page)*

Jersey Size*

Special Requests

Do you have a sibling that needs to be on the team?*

Any Medical Concerns?*

Previous Team/Coach

Product

U4/U6$55

U8/U10/U13$100

U4/U6 2nd Registration$45

U8/U10/U13 2nd Registration$90

Signature*

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