Fall 2024 Soccer Class Registration

Child #1 *

First Name

Last Name

Child #2 (if applicable)

First Name

Last Name

Choose Sessions *

KINDER / 1ST GRADE - THURSDAYS 1:30-2:30 PM

2ND - 4TH GRADE BOYS - THURSDAYS 3:15-4:15 PM

3RD - 6TH GRADE GIRLS - MONDAYS 3:15-4:15 PM

4TH - 6TH GRADE BOYS - TUESDAYS 3:15-4:15 PM

Parent Name *

First Name

Last Name

Phone *

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Waiver of General Liability *

By checking this box, I am releasing Patrick Ianni, Pristine Vibrations LLC, and their staff from any liability for my child's participation in any soccer or non-soccer related activities that take place prior, during or after soccer class. I also understand that there is an inherent risk in playing sports.

Payment Method ( Payment Needs to be completed by August 5th to take advantage of Early Early Bird Pricing) *

Cash/Check

Zelle

Venmo

Parent Signature

First Name

Last Name