ORLANDO SOCCER ACADEMY by thebestone

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									  ORLANDO SOCCER ACADEMY
                    3956 Town Center Blvd #546, Orlando, Florida 32837


           SOCCER SUMMER CAMP REGISTRATION FORM



PARTICIPANT’S NAME _______________________________________________________


AGE ____________     GENDER ________ M ________ F                    D.O.B_____________


PARENT’S NAME ____________________________________________________________


ADDRESS ___________________________________________________________________


CITY __________________________________________


HOME PHONE ____________________               EMER. PHONE ______________________



EMAIL _______________________________________________________________________



____________________________________________                 ________________________
SIGNATURE OF PARENT OR LEGAL GUARDIAN                        DATE



Please mail completed application to: Orlando Soccer Academy, 3956 Town Center
Blvd #546, Orlando FL 32837; Include Release & Waiver form along with payment.
Make checks payable to Jose Tortelero. Applicants with completed registration
packets will be given first priority for open slots.


*********************************************************************************

                               FOR OFFICE USE ONLY

Payment Date: ____________


Check #: ________

								
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