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  Free Soccer Clinic 
Registration Form
November 7th, 2015
Marshall Green Middle School Gym

Childs Name:___________________________Age:_____

Phone Number:___________________ Text: Yes or No


_____ 9 and under session 11:00am - 12:30pm

_____ 10 and older session 12:30pm – 2:00pm

Emergency Contact Name:___________________________

Phone Number:___________________________________

Parent Signature:_________________________________

Please fill out and return to school by October 23rd, 2015

Spring Soccer Registration will also take place during the clinic hours or you can go online to register at now.

Any questions please contact by phone or text:  Amy Muehlenbeck 989-332-8253 or Melissa Aldrich 989-245-8562

For more event information please follow us at and on Facebook at Birch Run AYSO Soccer

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