Sports: Spring Soccer 2019

NOTE: Please fill out one application for each child.

Jubilee staff will use the information you provide in order to help your child, and to ensure quality programs.  Your information will be kept private.

If you need assistance, please email Coach Chris Ramos at cramos@ymcadallas.org or call 214-957-3290.

Name *
Name
Date of Birth *
Date of Birth
Parent/Guardian #1 Name *
Parent/Guardian #1 Name
Parent/Guardian #1 Phone Number *
Parent/Guardian #1 Phone Number
Parent/Guardian #2 Name
Parent/Guardian #2 Name
Parent/Guardian #2 Phone
Parent/Guardian #2 Phone
Please check all the following conditions that your child has and indicate if medication needs to be dispensed at Jubilee *
Please mark medications your child takes and if they need to be dispensed at Jubilee
As the parent or legal guardian, checking the box below means that I give the above named child my consent to participate. By checking the box below I understand I am responsible for signing my child in and out at every practice and or game. I understand this is not a babysitting service, and that parent participation is encouraged. *