Quickstrike FC

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Soccer School Registration

BEEKMAN FOOTSKILLS CLINIC ... Improve Performance and Gain Confidence

$85 Per Class

Fee:$85

Referral/Discount Code:

Registration Details

First Name:

Last Name:

Gender:

Male Female

Date of Birth:

Month:

Day:

Year:

Position:

Field Player Goalkeeper

Street:

City:

State:

Zip:

Current Club Team:

(if any)

Parent/Guardian:

Home Phone No:

Cell/Alternate Phone No:

Email Address:

T-Shirt Size:

Youth: Medium Large

Adult: Small Medium Large

Any Allergies:

I have read and agree to Quickstrike FC Terms & Conditions.

PO Box 10142, Newburgh, NY 12552 Hotline: 845-534-9031 Email: info@QuickstrikeFC.com