TOPSoccer Registration

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Spring 2023 Sessions:

Wednesday, May 10
Wednesday, May 17
Wednesday, May 24
Wednesday, May 31

All sessions will run from 6:00-7:00 pm

Fields for Kids is located at:
2500 Hauser St
La Crosse, WI 54603

Rush WI West - TOPSoccer Spring 2023

Participant First Name *

Participant Last Name *

Participant Date of Birth

YYYY

Gender *

Female

Male

T-Shirt Size *

Youth Extra Small

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Parent/Guardian First and Last Name *

Parent/Guardian Email *

Parent/Guardian Phone *

Address *

City, State, Zip *

Medical Insurance Carrier *

Medical Insurance Member ID *

Medical Insurance Group Name *

Emergency Contact First and Last Name *

Emergency Contact Phone *

Please provide any accommodations that your child may need *

Include notes about the participant such as allergies, preferences, or special care instructions. *

Submit

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