HALO Elite Footwork & Soccer and Training

HALO Elite Footwork & Soccer and Training
PLEASE SELECT LOCATION
Select your school for pick-up ( for families needing pick up)
Day of Week
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
2 digit month, 2 digit day, 4 digit yearDate
MAIN ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

4 sessions (4:30- 5:30)$120.00

Small group soccer skills training (drop off) (Mon K-2nd) or Wed (3-5th)

8 sessions (4:30-5:30)$240.00

Small group soccer skills training (drop off) (Mon K-2nd) or Wed (3-5th)

4 sessions with Pick up from School (4:30-5:30)$300.00

Small group soccer skills training with pick up from selected schools. Monday (k-2nd) or Wednesday (3rd-5th)

Enter coupon

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