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Select Class*
Student #1 Information
Student #1 Full Name*
First Last
Student #1 Date of Birth*
Date Format: MM slash DD slash YYYY
Student #1 Jersey Size*
Student #1 Shorts Size*
Allergies/Prior Health Issues:
Student #2 Information (Optional)
Student #2 Full Name
First Last
Student #2 Date of Birth
Date Format: MM slash DD slash YYYY
Student #2 Jersey Size
Student #2 Shorts Size
Allergies/Prior Health Issues:
Student #3 Information (Optional)
Student #3 Full Name
First Last
Student #3 Date of Birth
Date Format: MM slash DD slash YYYY
Student #3 Jersey Size
Student #3 Shorts Size
Allergies/Prior Health Issues:
Parent/Guardian Information
Parent/Guardian Full Name:*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Cell Phone*
How did you find out about us?*
Additional Comments
Certifikid Code (if necessary)
Permission to Participate:*
- By checking here, I hereby give my child permission to participate in the QuickFeet Soccer for Kids programs. I understand that soccer/football is a competitive sport that may run the risk of injuries. I agree to hold the QFSK, partners, sponsors, and other members involved harmless from all liability associated with my child.
Permission to Medical Attention:*
- By checking here, I hereby give permission for any medical attention to be administered to my child in the case of any accident, injury, sickness, and or any medical occurrence until such time that I may be contacted. I also assume responsibility for any such treatment.
Terms & Conditions*
- I accept all Terms & Conditions.

Student #1 Information

Student #2 Information (Optional)

Student #3 Information (Optional)

Parent/Guardian Information