Enrollment Form - Kansas Premier Soccer League

Soccer Performance Camp and Combine

Presented by KPSL & iRISE performance.
Where: 9701 W. 67th Street., Merriam Kansas
Dates: Saturdays between June 21-July 26 2014
Download the camp flyer here for more info

All participants must complete the Medical release form and bring it to the first session. Download the form.

Player Information
Name*
First Last
Gender*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Birthday*
MM slash DD slash YYYY
Age Group / Cost
Primary Phone Number*
Primary Phone Type
Shirt Size*
Player Type*
Emergency Contact Name*
First Last
Emergency Contact Phone Number*
Emergency Contact Phone Type
Added Comments
Guardian 1 Information
Name*
First Last
Guardian 1 Address
- Same address as player
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email
Enter Email Confirm Email
Primary Phone Number*
Primary Phone Type
Secondary Phone Number
Secondary Phone Type
Guardian 2 Information
Guardian 2 Address
- Same address as player
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email
Enter Email Confirm Email
Primary Phone Number
Primary Phone Type
Secondary Phone Number
Secondary Phone Type
Total
$0.00

Soccer Performance Camp and Combine

Player Information

Guardian 1 Information

Guardian 2 Information