Winter Training with Derek Smith

All winter training will be done at the Canton Storage Facility.  Cost is $75.00/players, two or more is $130.00/family per month.

By filling out this form you are committing your child to attend the months you choose below, please make all checks payable to Derek Smith...

Players Information:

First Name
Last Name
Age
Sex Male Female
Current Team

Parent Contact Information:

Name
Cell Phone
Home Phone
Primary Email

 

Please select which months you plan on attending: **Please only select the months you know your child will attend.

November
December
January
February

 

Author information goes here.
Copyright © 1999 [Ambush Soccer]. All rights reserved.
Revised: 11/04/08