Fall 2025 Portland Soccer Club Registration
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Email *
Players First Name *
Players Last Name *
Shirt Size *
Gender *
Birthdate *
MM
/
DD
/
YYYY
Player Address *
City *
Zip Code *
Parent 1 First Name *
Parent 1 Last Name *
Parent 1 Email Address *
Concussion and Medical release forms will be emailed to this address
Parent 1 Phone Number *
Parent 2 First Name
Parent 2 Last Name
Parent 2 Email Address
Parent 2 Phone Number
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