PEORIA SOCCER CLUB FUTURES

Spring Player Registration Form

You will be contacted by the Peoria Soccer Club
to confirm acceptance in the PSC Futures Program.

PLAYER AGES: 4 - 7 years old (born between 8/1/2004 and 7/31/2008)

PROGRAM COST: $40 per player - Please mail payment to:
PSC Futures
P.O. Box 9813
Peoria, IL 61612

SESSION DATES:
Monday Session: 4/16, 4/23, 4/30, 5/7, 5/14, 5/21, 6/4, & 6/11
Wednesday Session: 4/18, 4/25, 5/2, 5/9, 5/16, 5/23, 6/6, & 6/13

SESSION TIMES: All Sessions are 4:30 PM - 5:15 PM

NOTE: each session is limited to 12 players!

SEE OUR WEBSITE: WWW.PEORIASOCCERCLUB.ORG FOR MAPS TO OUR PSC TRAINING FIELDS

Player First Name:

Player Last Name:

Player Birth Date:

Current Soccer Team - enter N/A if none:

Player T-shirt Size Requested:

Youth Small:
Youth Medium:
Youth Large:

Player Gender:

Boy:
Girl:

Peoria Futures Session Requested:

Monday Session:
Wednesday Session:

Contact Information

Parents' Names:

Address:

Street:
City:
State :
Zip:

Home Phone:
Cell Phone:
Cell Phone 2 (optional):
E-mail:
E-mail 2 (optional):
E-mail 3 (optional):

Other information we should know about your player including any special requests:

Player First Name:
Player Last Name:
Player Birth Date:
Current Soccer Team - enter N/A if none: Player T-shirt Size Requested:

Peoria Futures Session Requested:
Monday Session: Wednesday Session:

Contact Information
Parents' Names:
Address:
Street: City: State : Zip:
Home Phone: Cell Phone: Cell Phone 2 (optional): E-mail: E-mail 2 (optional): E-mail 3 (optional):