Registration for Super F Academy

Sun, 10/11/2009 - 12:19pm — admin

Choose Session: *

Academy Session 2 (Feb – Mar)

Gender: *

Boys/male

Girls/female

Player name: *

Date of birth: *

Parent #1 name: *

Parent #1 email: *

Parent #2 name:

Parent #2 email:

Mobile #: *

Home #: *

Street address: *

City: *

State: *

Zip: *

Emergency contact #1:

Emergency #1 phone:

Emergency contact #2:

Emergency #2 phone:

Futsal experience: *

Has played futsal or soccer before

Is new to futsal or soccer

Has never played futsal or soccer

Tell us about the player:: *

Please include any allergies, injuries or special education information. Information is for use by our Director of Futsal and Academy Director only and will not be shared.

All payment is currently completed by check. Please mail your check to: Massachusetts Futsal 849 Boston Post Rd. #8F Marlborough, MA 01752-3756 Checks should be payable to Massachusetts Futsal in the amount of $150 (for one session) or $250 if you are paying now for both sessions. If you are paying for both sessions now you will be invited to a special pre-season clinic in November with our professional staff and the Boston Breakers. Please print the name of the team in the “memo” line and be sure a phone number is on the check. Registration is not completed until your check arrives.

I am mailing a check in the amount of : * $

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