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2018-19 LSC Registration

Parent/Guardian 1 First Name(*)
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Parent/Guardian 1 Last Name(*)
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Parent/Guardian 1 Address(*)
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Parent/Guardian 1 City(*)
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Parent/Guardian 1 Zip(*)
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Parent/Guardian 1 E-Mail(*)
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Parent/Guardian 1 Home Phone
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Parent/Guardian 1 Cell Phone
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Secondary parent/guardian information is optional. Providing e-mail address and cell phone numbers to aid in club communications.
Parent/Guardian 2 First Name
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Parent/Guardian 2 Last Name
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Parent/Guardian 2 Address
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Parent/Guardian 2 City
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Parent/Guardian 2 Zip
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Parent/Guardian 2 E-Mail
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Parent/Guardian 2 Home Phone
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Parent/Guardian 2 Cell Phone
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Player 1 Information
Player First Name(*)
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Player Last Name(*)
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Gender(*)
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Player Birth Date(*)
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Player 2 Information
Player First Name
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Player Last Name
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Gender
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Player Birth Date
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Player 3 Information
Player First Name
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Player Last Name
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Gender
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Player Birth Date
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Player 4 Information
Player First Name
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Player Last Name
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Gender
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Player Birth Date
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Player 5 Information
Player First Name
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Player Last Name
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Gender
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Player Birth Date
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I certify as the submitting parent/guardian that I and my child(ren) have read the CASL Concussion Release document and acknowledge the risk in playing soccer.(*)
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Payment Options

Paying during online registration provides a $5 discount per child. You may choose not to pay at his time

If you are paying in installments, the first payment is due July 17th, the second payment is due November 1st. High School teams are ineligible to play during their high school season, HS girls will play LSC fall only and HS Boys will play spring only.

Parents have the option to pay their fees by check, cash, or credit card. Parents opting to pay via credit card can pay via the PayPal, note, credit card payments will incur an additional processing fee from PayPal. Cash or checks can be given to your child's coach/manager at practice games.

Player 1 Payment(*)

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Player 2 Payment

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Player 3 Payment

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Player 4 Payment

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Player 5 Payment

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Note
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Total
0.00 USD