Registration Form | Seminole Youth Soccer

1st Parent Name*

First Last

1st Parent Email*

1st Parent Cell Phone*

2nd Parent Name

First Last

2nd Parent Email

2nd Parent Cell Phone

Address*

Street Address City State ZIP Code

Home Phone

Would you like to Coach a team?

Head Coach
Assistant Coach

Would you like to be a team Mom or Dad?

Team Mom
Team Dad

How did you hear about us?*

Number of Children you are Registering*

My child(ren) played in Spring 2020 - Apply my credit to this season.

Enter the number of children that you are registering that played in Spring 2020 during the shortened season.

Price: -$75.00 Quantity:

Child's Name*

First Last

Sex*

Male
Female

If your child played in Spring 2020, do you want to remain on the same team?*

Yes
No
Did not play in Spring 2020

Date of child's birth*

Age as of 9/1/2020*

School (If Applicable)

Registration fee - Does NOT include a new uniform

One Child: $150
Multi Child Discount: $145 each
Head Coach's Child: $75
Assistant Coach's Child: $130

Uniform Size - If new player or needs a new uniform

New Uniforms are $25. Please select a uniform size.

New Uniform

Price: $25.00

Special Requests

Second Child's Name

First Last

Sex*

Male
Female

If your child played in Spring 2019, do you want to remain on the same team?*

Yes
No
Did not play in Spring of 2018

Date of second child's birth*

Age as of 9/1/2019

School (If Applicable)

Registration fees - Second Child - Does NOT include a new uniform

One Child: $150
Multi Child Discount: $145 each
Head Coach's Child: $75
Assistant Coach's Child: $130

Uniform Size - Second Child - If new player or needs a new uniform

New Uniforms are $25. Please select a uniform size.

New Uniform - Second Child

Price: $25.00

Special Requests

Third Child's Name

First Last

Sex*

Male
Female

If your child played in Spring 2019, do you want to remain on the same team?*

Yes
No
Did not play in Spring 2019

Date of third child's birth*

Age as of 9/1/2018

School (If Applicable)

Registration fees - Third Child - Does NOT include a new uniform

One Child: $150
Multi Child Discount: $145 each
Head Coach's Child: $75
Assistant Coach's Child: $130

Uniform Size - Third Child - If new player or needs a new uniform

Please select a uniform size.

New Uniform - Third Child

Price: $25.00

Special Requests

Fourth Child's Name

First Last

Sex*

Male
Female

If your child played in Spring 2019, do you want to remain on the same team?*

Yes
No
Did not play in Spring 2019

Date of fourth child's birth

Age as of 9/1/2019

School (If Applicable)

Registration fees - Fourth Child - Does NOT include a new uniform

One Child: $150
Multi Child Discount: $145 each
Head Coach's Child: $75
Assistant Coach's Child: $130

Uniform Size - Fourth Child - If new player

New Uniforms are $25. Please select a uniform size.

New Uniform - Fourth Child

Price: $25.00

Special Requests

One Player Late Registration Fee

Price: $25.00

Two Player Late Registration Fee

Price: $50.00

Three Player Late Registration Fee

Price: $75.00

Four Player Late Registration Fee

Price: $100.00

Registration Fees Total

$0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

When you click submit a copy of your registration information will be emailed to the 1st Parent email listed above.

Please be advised: Refund Policy: ***No refund after August 31, 2020 ***There is a $25 processing fee for any and all refunds. $25 late fee after August 23, 2020 Season Dates: Our kick off is scheduled for September 12th

Fall 2020 Registration