Valley Soccer Academy
Proudly presents
TADPOLE AND ROADRUNNER SOCCER
Location: TRINITY ASSEMBLY OF GOD in Fairmont
Offer 3 Four week programs
Sundays
1st program - November 20 Dec 4,11,18
2nd prog January 8,15,22,29
3rd prog February 5,12,19,26
Time/Age:
Age:4yr Boys/Girls
Time:1-2pm
Age:5-6-7 Boys/Girls
Time: 2-3pm or 3-4pm
Cost $35/ per program
For more information please log onto www.vsasoccer.com
Facebook/Valley Soccer Academy
Must Call or e-mail to reserve spot on roster!! mail@vsasoccer.com
Only 8-10 students per class
Mail Registration to : Valley Soccer Academy
RR 4 Box 505A Fairmont, WV 26554
Make check payable to: Valley Soccer Academy
For further information on all indoor events call: 304-669-5270
www.vsasoccer.com
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Player Registration(Road 11-12)
Player Name:________________________________Age Gender_____
Tel Cell___________________________Home____________________________
ROAD 1st Program ( ) 2nd ( ) 3rd( ) time 1pm( ) 2pm( ) 3pm( )
I certify that my child is in excellent physical health and may participate in strenuous physical activities, including soccer to be played at camp/clinic. Permission is granted for my child to receive emergency medical treatment if needed. I hereby release said camp/clinic, Valley Soccer Academy/staff and Trinity Assembly of God from any and all liability claims, for injuries or illness occurred while attending/observing camp/clinic. I confirm that I am a parent/guardian of the minor named above.
Parent Name: Print_____________________________________________________
Parent/Guardian Signature:_____________________________________
E-mail(Please print clearly)_____________________________________
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