Benton High School Boys Soccer Mini Clinic
Come join the BHS Boys Soccer Team for a fun filled afternoon of learning soccer skills to include kicking,
passing, dribbling, shooting, and working as a team in a fun supportive environment. Participants will be split into co-ed groups according to their grade. Please fill out this form and submit the $35 payment to @bhsboyssoccer . Clinics will be held at the students school if at Benton Elementary, Legacy Elementary and Benton Intermediate. Kingston students will need to be picked up in carline and transported to Benton High School for the clinic. 
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Participant's First and Last Name *
Participant's Age *
Participant's Grade *
Participant's School *
T-Shirt Size *
Parent/Guardian Name *
Parent/Guardian Email Address *
Parent/Guardian Phone Number  *
Emergency Contact Name *
Emergency Contact Number *
Allergies or Any Other Medical Condition(Please write "none" if there are no allergies or medical conditions.) *
I confirm that I am the parent or legal guardian of the child listed on this form. I hereby grant permission necessary to allow participation in the Benton High School Soccer Clinic. I agree to release to hold harmless Benton HS, the affiliates of Benton HS, and the respective participants/sponsors from any and all liability for any injury arising out of or connected with the soccer clinic that the minor may incur or sustain during all activities associated with the clinic. Please type name in below. **All Kingston registrants agree to transport their child from KES to BHS for the clinic. *
I have sent the clinic fee of $35 to 
@bhsboyssoccer
Please type your PayPal name below.
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