HALO Soccer Training

HALO Soccer Training
PLEASE SELECT LOCATION
Select your school for pick-up ( for families needing pick up)
PRIMARY GUARDIAN

First NameLast Name
PRIMARY GUARDIAN'S EMAIL
example@example.com
PRIMARY GUARDIAN'S PHONE

Area CodePhone Number
SECONDARY GUARDIAN

First NameLast Name
SECONDARY GUARDIAN'S EMAIL
example@example.com
SECONDARY GUARDIAN'S PHONE

Area CodePhone Number
CHILD'S NAME

First NameLast Name
CHILD'S DATE OF BIRTH

MonthDayYear
Date
MAIN ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PAYMENT

4 sessions (4:30- 5:30). Small group soccer skills training (drop off)

4 sessions (4:30- 5:30)$140.00

Small group soccer skills training (drop off)

8 sessions (4:30-5:30). small group soccer skills training (drop off)

8 sessions (4:30-5:30)$275.00

small group soccer skills training (drop off)

4 sessions with Pick up from School. Small group soccer skills training with pick up from selected schools

4 sessions with Pick up from School$260.00

Small group soccer skills training with pick up from selected schools

Total $0.00

CREDIT CARD

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

BILLING ADDRESS

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

BILLING EMAIL ADDRESS
example@example.com
Should be Empty: