Free Soccer Clinic

Register for the Free Soccer Clinic at Tourtellotte!

Please enter the information below to register for the free clinic.
Child's Name *

First Name Last Name
Child's Birth Date *

Month Day Year
Gender *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Any medical conditions or allergies?
Additional Comments:
We'd welcome any donation amount to help us continue to provide great services to the youth in the Quiet Corner! No donation is necessary to register for this free clinic.

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USD Donation
By submitting this form, I agree to the following:

I hereby release Liverpool Football Club and Northeast Opportunities for Wellness, Inc. from any and all claims of liability, personal injury or property damage arising from participation in this program. I understand that participation in sports involves some element of physical contact and I certify that my child is in good health and able to participate in all activities. If any attention is required for illness or injury, I give my permission to LFSC or NOW staff member(s) for such care. I give consent for my child to be photographed or videotaped during the program and release use of the images by LFSC or NOW for promotional purposes.
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Register for the Free Soccer Clinic at Tourtellotte!