2022 Starfinder Youth Pick-Up Soccer Registration & Waiver
What: Youth Pick-up Soccer at Starfinder’s Indoor Turf Facility
Who:  Youth in 8th - 12th grade
When: Every Friday from 4:30pm-6:30pm, starting 4/8/2022
Where: Starfinder Foundation, 4015 Main St., Philadelphia


Cost:  $1 per session (pay at the door)

Fill out registration form and waiver below.  Youth under the age of 18 need parent/guardian signature on Waiver.

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First Name *
Youth's Last Name *
Youth's Pronouns *
Youth's Date of Birth *
MM
/
DD
/
YYYY
Current Grade *
School Youth is Currently Attending *
Youth's Gender *
Required
Race (check all that apply) *
Required
Home Street Address *
Home City *
Home Zip Code *
Youth's Phone Number *
Youth's Email *
Is it okay for Starfinder staff to text and/or email youth about program schedule and activities? *
Has the youth participated in Starfinder Programs before? (check all that apply) *
Required
How did you hear about this program? *
Guardian/Emergency Contact Name *
Guardian/Emergency Contact Relationship to Youth *
Guardian/Emergency Contact Phone Number *
Guardian/Emergency Contact Email *
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