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2021 Spring LSC Registration
Parent/Guardian 1 First Name
(*)
Invalid Input
Parent/Guardian 1 Last Name
(*)
Invalid Input
Parent/Guardian 1 Address
(*)
Invalid Input
Parent/Guardian 1 City
(*)
Invalid Input
Parent/Guardian 1 Zip
(*)
Invalid Input
Parent/Guardian 1 E-Mail
(*)
Invalid Input
Parent/Guardian 1 Home Phone
Invalid Input
Parent/Guardian 1 Cell Phone
Invalid Input
Secondary parent/guardian information is optional. Providing e-mail address and cell phone numbers to aid in club communications.
Parent/Guardian 2 First Name
Invalid Input
Parent/Guardian 2 Last Name
Invalid Input
Parent/Guardian 2 Address
Invalid Input
Parent/Guardian 2 City
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Parent/Guardian 2 Zip
Invalid Input
Parent/Guardian 2 E-Mail
Invalid Input
Parent/Guardian 2 Home Phone
Invalid Input
Parent/Guardian 2 Cell Phone
Invalid Input
Player 1 Information
Player First Name
(*)
Invalid Input
Player Last Name
(*)
Invalid Input
Gender
(*)
Please Select
Male
Female
Invalid Input
Player Birth Date
(*)
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Player 2 Information
Player First Name
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Player Last Name
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Gender
Please Select
Male
Female
Invalid Input
Player Birth Date
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Player 3 Information
Player First Name
Invalid Input
Player Last Name
Invalid Input
Gender
Please Select
Male
Female
Invalid Input
Player Birth Date
Month
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2014
Invalid Input
Player 4 Information
Player First Name
Invalid Input
Player Last Name
Invalid Input
Gender
Please Select
Male
Female
Invalid Input
Player Birth Date
Month
01
02
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12
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Day
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Year
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2013
2014
Invalid Input
Player 5 Information
Player First Name
Invalid Input
Player Last Name
Invalid Input
Gender
Please Select
Male
Female
Invalid Input
Player Birth Date
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
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Year
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2013
2014
Invalid Input
I certify as the submitting parent/guardian that I and my child(ren) have read the
CASL Concussion Release
document and acknowledge the risk in playing soccer.
(*)
Certified
Invalid Input
Next >
Payment Options
Parents have the option to pay their fees by check, cash, or credit card. Parents opting to pay via credit card can pay via the PayPal, note, credit card payments will incur an additional processing fee from PayPal. Cash or checks can be given to your child's coach/manager at practice games. If you choose a method other than PayPal, select offline payment.
Player 1 Payment
(*)
Offline Payment
Spring - 100.00 USD
Spring Scholarship - 50.00 USD
Invalid Input
Player 2 Payment
Offline Payment
Spring - 100.00 USD
Spring Scholarship - 50.00 USD
Invalid Input
Player 3 Payment
Offline Payment
Spring - 100.00 USD
Spring Scholarship - 50.00 USD
Invalid Input
Player 4 Payment
Offline Payment
Spring - 100.00 USD
Spring Scholarship - 50.00 USD
Invalid Input
Player 5 Payment
Offline Payment
Spring - 100.00 USD
Spring Scholarship - 50.00 USD
Invalid Input
Note
Invalid Input
Total
0.00 USD
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