Coerver Cup Futsal League Registration Form

Charlie Cooke Futsal Registration Form

To register by telephone: call Kids First (513) 489-7575
Waiver Form >> Download, fill out and bring to Kids First

* Specifies a Required field in order to submit the form

TEAM INFORMATION:
* Team Name:
* Parent/Coach:
* Age Group :
* Gender :
* Telephone/Cell Number:	( )
* Mailing Address:
* City:	* State: * zip code:
* Email Address:
* Specifies a Required field in order to submit the form

SESSION II: Jan 30; Feb 6, 13, 20, 28; Mar 6, 14, 20

IMPORTANT INFORMATION

Registration/waiver/medical release form must be completed either before or on the first day of the session. (Click here for downloadable online form)
To view this document you will need Adobe Acrobat Reader (a free download)

TEAM DISOUNT:
$50 off when you register before October 17th + DVD & New Era Book for the coach!! $150 in Value.

FUTSAL FEES:
$495 ($445 with team discount)
$8 REF fees paid at each game.


PAYMENT INFORMATION:

* Payment Method:
* Credit Card Number:	* exp.date
* Name on Card:
* Specifies a Required field in order to submit the form

ADDITIONAL INFORMATION:

HOW DID YOU HEAR ABOUT US (if word of mouth, from whom?):


* I understand that submitting this registration is a REQUEST for classes. I realize by submitting this request, I am not guaranteed a class spot. Kids First will notify me ONLY if there is a problem. NO NEWS IS GOOD NEWS. * I also understand that my credit card will not be charged until class placement occurs. Upon class placement, my card will be charged.