Kickstarters Spring 2023

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Kickstarters Soccer/Kickstarters Elite Winter Session will be in small groups with approximately 10 children. Program will run for 7 weeks on Saturdays from March 18th to April 29th, 2023. Classes will be held at Lakeside Early Learning (Old St. Michael's school). Cost is $100 for Kickstarters and $125 for Kickstarters Elite (5-7 years old) and includes a Kickstarters T-shirt.

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Child's Name

Child's Birthdate

YYYY

T-shirt size

Youth Small

Youth Medium

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Class Times

18 months-2 1/2 years- 9:00-9:35

2-4 years- 9:40-10:20 (Waitlist)

2-4 years- 10:30-11:10 (Waitlist)

2-4 years -11:20-12:00 (Waitlist)

2-4 years- 12:10-12:50 (Waitlist)

2-4 years- 1:00-1:45 (Waitlist)

4-5 years- 2:00-2:55 (ELITE) (Waitlist)

5-7 years- 3:00-3:55 (ELITE)

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Parent's Name

Parent's Phone Number

Email Address

Emergency Contact (Name and Phone Number)

Insurance Company

Hospital

St. Lukes

Essentia

Other:

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Allergies/Medical History

We would like to use pictures from the sessions (i.e. action pictures) on the Kickstarters Website. Do you consent to allow your child(ren)’s photo(s) to be used?

Yes

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Payment Choice

Venmo (Sarah-Wilmot-4)

Check (Kickstarters Soccer-804 Valley Dr. Duluth, MN 55804)

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A copy of your responses will be emailed to the address you provided.

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