HPD Academy Form - High Plains Drifters Soccer Club

HPD Academy Form - High Plains Drifters Soccer Club

High Plains Drifters
Drifters Academy
Academy Session: Spring / Fall
Academy Year:
Player Name:
Player Gender: Male / Female
Home Phone:
Cell Phone 1:
Cell Phone 2:
Email Address:
Player Age Group:
DOB
Academy Only:
$65
Academy & League:
$125
Shirt Size:
Office Use Only
Registration thru ASA:
$
Cash:
$
Check:
$
Chk #
Credit Card:
$
CC #
Exp Date:
Signature
Total
$