Summer 2010 Outdoor Lil' Kickers Session Santa Rosa, Windsor, Petaluma June 15-August 20 No membership required (for outdoor classes only).             Registration Form Please print this out and fax with a waiver to 707-581-1964, or mail it to: Sports City, Attention Lil' Kickers, 921 Piner Road, Santa Rosa, CA 95403 Questions:  please call 707-526-2884.  You can also come to either facility and register in person. Register at any time during the session! Childs Name Registering for:   Summer Outdoor 2010 Session  Dates: June 15-August 20  Membership Waiver PDF   Membership Waiver Spanish PDF required to complete registration Please select the class(es) you are registering for. 2-3 Years Parent and Child Classes Tuesday 4:00 PM Windsor Wednesday 4:00 PM Santa Rosa Friday 4:00 PM Petaluma 4-6 Years Beginning Tuesday 4:00 PM Windsor Wednesday 4:00 PM Santa Rosa Friday 4:00 PM Petaluma 4-6 Years Intermediate Tuesday 5:00 PM Windsor Wednesday 5:00 PM Santa Rosa Friday 5:00 PM Petaluma 7-10 Years Tuesday 5:00 PM Windsor Wednesday 5:00 PM Santa Rosa Friday 5:00 PM Petaluma Refund Policy Full refunds will be issued if the request is received prior to a session beginning or within 7 days after the date of your first class.  If a refund is requested after the first 7 days of the session start date or date of your first class, a $20 cancellation fee will be charged in addition to the price of classes that have already taken place during the session.   Credit card payment information (MasterCard/Visa only. Cash/checks are not accepted):                                                                                Credit Card Number:  Expiration Date:   Amount  $ Name on Credit Card:                    Signature: All information is kept confidential.

PLAYER INFORMATION: To be completed by Parent/Legal Guardian Returning Lil' Kicker? YES      NO Player Name (First, Last) Date of Birth            Age          Sex Street Address City State Zip Parent/Guardian Name Home PhoneWork Phone Cell PhoneE-Mail Address Emergency Contact Emergency Phone

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