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  Free Soccer Clinic 
Registration Form
November 7^th, 2015
Marshall Green Middle School Gym

Childs Name:___________________________Age:_____

Phone Number:___________________ Text: Yes or No

Email:__________________________________________

_____ 9 and under session 11:00am - 12:30pm

_____ 10 and older session 12:30pm – 2:00pm

Emergency Contact Name:___________________________

Phone Number:___________________________________

Parent Signature:_________________________________

Please fill out and return to school by October 23^rd, 2015

Spring Soccer Registration will also take place during the clinic hours or you can go online to register at eAYSO.org now.

Any questions please contact by phone or text:  Amy Muehlenbeck 989-332-8253 or Melissa Aldrich 989-245-8562

For more event information please follow us at www.birchrunsoccer.com and on Facebook at Birch Run AYSO Soccer

Click here to Download Form