2022 Belfast Youth Summer Soccer Registration Form

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This form MUST be filled out for each player who is registering

Your child's coach will be contacting you in early June to schedule practices.
Games will start in late June or early July.

Price: $20 per player
Family Maximum: $60

(If you are signing up more than one player, please leave a comment at the end with the names of the players who are already signed up & paid for)

Email *

Player's Name *

Player's Date of Birth *

Player's Grade in Fall 2022

Parent/Guardian Name (Primary) *

Parent/Guardian Phone Number (Primary) *

Parent/Guardian Name (Secondary)

Parent/Guardian Phone Number (Secondary)

Player Allergies/Asthma/Special Medications *

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