Buckhorn Soccer Camp
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Soccer Camp Registration Form
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Soccer Player's Name
*
First
Middle
Last
Gender
*
Male
Female
Non-binary
Prefer not to say
Other
Date of Birth
*
MM/DD/YYYY
the Parent/Guardian Email
Parent/Guardian Name
*
First
Middle
Last
Parent/Guardian Email
*
Parent/Guardian Phone
*
Program
*
7/8 Year Olds
9/10 Year Olds
10/11 Year Olds
Choose your desired Program
Permission & Agreement
*
I agree
Description
I agree to the following charge:
*
Registration Fee – $80.00
Stripe Credit Card
*
Credit Card field is disabled, Stripe keys are missing.
Medical Information
Any allergies or conditions (optional)
Submit
