Academy Registration Form

 

   Use a separate registration for each program and each player.

 

 

    Player name: __________________________Age:________

 

   Academy Program Title______________________________

 

   Parent’s Name:  _____________________________________

 

   Address: ___________________________________________

 

   City: __________________________ Zip: ________________

 

   Contact #:

   Home/Work: __________________   Cell: ________________ 

 

 

   Emergency contact number:      _____________________

 

 

   Enclosed Check Number:           ___________________

 

   Please make checks payable to: 

       Savannah International Soccer Academy (SISA) 

   

   I give permission for________ to participate in this program,

 

   Signed by Parent or Guardian __________________________

 

 

   Please attach check and send this Registration form to:

   Savannah International Soccer Academy

   PO Box 61148

   Savannah

   Georgia 31420