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REC | FPC Fall Soccer 2021 on Saturday, August 14, 2021 @ 2:00 PM

Put the name and the address of the child you are registering in the "Attendee" boxes above. You may use your cell phone and email if your child does not have them. 
*Child's Date of Birth:
*What Division/Age Group is Your Child Playing In?
*Child's Gender:
*Child's School:
*School Dismissal Time:
*Main Family Cell Phone:
*Main Family Email:
Practice Information
Please mark on what days and what time frames you can (yes) or cannot (no) attend practices.
*Early evening sometime between 3:00-5:00 PM
*Late evening sometime between 5:00-7:00 PM
Parent Information
*Parent 1 Name:
*Parent 1 Cell Phone:
*Parent 1 Email:
Parent 2 Name:
Parent 2 Cell Phone:
Parent 2 Email:
Emergency Contact (Non-Parent - Over 18)
*Emergency Contact Name
*Emergency Contact Cell Phone
*Emergency Contact Relationship
Additional Information
If you are on a preformed team, please contact the coach for the team code and list here.
Coaches Name:
Player's Name
Player's Name
Player's Name
*Would you like to coach this season?
*By typing my name below I acknowledge that I have read and agree to the FPC Recreation "Acknowledgement of Risk Full and Complete Indemnity, Release and Waiver of Liability" form. 
By typing my name below I understand there is a $10 cancellation fee associated with a players cancellation.
Additionally, no refunds without prior permission occur after week two of games in the season
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