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2024 Soccer
*
First Name:
*
Last Name:
*
Gender:
Boys
Girls
*
Date of Birth:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
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8
9
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24
25
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31
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
*
2024-25 Grade:
Pre-K4
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
*
Uniform needed (Grades 3-8). We will follow up with order & payment info in late-May.:
Yes
No (all PreK-2nd Grade Select)
*
Does your child additionally play Club Soccer?:
Yes
No
*
Address:
*
City:
*
State:
*
Zip Code:
*
Parish:
Immaculate Conception
Church of the Nativity
Other
Interested in volunteering (if so, please list volunteering parent in the next field)?
*
Parent 1 First Name:
*
Parent 1 Last Name:
*
Primary Email:
*
Primary Cell (#s Only):
Parent 2 First Name:
Parent 2 Last Name:
Secondary Email:
Secondary Cell (#s Only):
I agree not to hold the player's team, league, Immaculate Conception Athletic Association, the program, Immaculate Conception/Nativity Parish, the Archdiocese of Baltimore or any other individual connected therewith responsible for any injury received by my child/ward as a result of playing/practicing in this program and will hold them harmless from any damages whatsoever as a result of any injury. Further, I understand that there is no applicable insurance through the program in the event my child/ward is injured. I hereby grant my permission in my absence or the coach or supervisor of my child/ward to authorize medical treatment in the case of emergency. I have read the above injury waiver and release and agree to its terms:
I agree
*
General Requests (will honor to the extent possible):
* indicates required fields
SELECT FEE
$80.00 - In House Clinic (PreK-4 & K only)
$100.00 - ABSP Clinic (Grades 1 & 2)
$150.00 - ABSP League Registration (Grades 3-8)
Field Maintenance Donation Option($5)
Field Maintenance Donation Option($10)
Field Maintenance Donation Option($20)