Registration for Fall 2010

Fall session registration is $50.00 per child with a $10.00 discount for siblings given at registration or opening day.

Child First Name          

Child Last Name          

Age            3  4  5  6

Gender             Male     Female

Date of Birth            MM/DD/YYYY

E-Mail           

Phone #             ###-###-####

Address  

City         ST         ZIP 

Parents First          

Parents Last          

Shirt Size           YS YM YLAS AM

Would you like to Coach?           YES NO

Kids to Play With

NOW AVAILABLE!!
ON-Line Pay

Submission of registration will take you to payment page.  Please e-mail microadmin@dothanmicrosoccer.com with any problems or questions.