Child's Name:
Birthday:
Address:
State/Zip:
City:
Age:
Grade
By the hour..........: $20.00
2+ hours tot. of..: $30.00
Impact Youth Soccer
then fill out complete Information below...then press 'Submit' button to complete registration!
1) PLEASE Click on Price
   to PAY/ Register...
Parent's Name:
Email Add:
Cell#: 
One Time Pay... December to April 2020
Please Note: If payment is not made...
$250.00
$250.00
Sign-Up TODAY!
you are NOT registered!
Includes...Full Uniforms and Insurance!
Pay On Site:
Weekly Training &
Play, 3 Hours