Recreation Ministry

2010 Centennial Recreation Ministry

Spring Kids Soccer/Adult Kickball Registration

Parent/Guardian Information

Highlight and Replace information in boxes with your information!

Name:

WOULD YOU LIKE TO COACH?

YesNo

PLEASE CHECK ONE:

Single Married Divorced Widowed

Address:

Email:

Phone Numbers:

Church Name:

Sunday School Class:

Do you or your child have a medical condition we should know about? (For those playing a sport)

Child's Participant Information

Name:

Date of Birth:

Kids Soccer Fee $30.00

(Includes Jersey, Shorts & Socks)

Select Age: 5-6 7-8 9-10 11-12

Kids Jersey Size:

Select Size: YS YM YL YXL

Youth/Adult Participant Information

Name:

Date of Birth:

Youth/Adult Kickball Fee $20.00

(Includes Jersey)

Select Age:

13-17

18-Up

Adult Jersey Size:

Select Size: AS AM AL AXL AXXL

NAMBLINK

Operation Prayer Cover