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PRIVATE SOCCER
Players First Name
*
Players Last Name
*
Email Address
*
Re-enter email. Both must match
*
Date Of Birth mm/dd/yyyy
*
HOW MANY PLAYERS WILL BE IN YOUR PRIVATE LESSON?
*
1 PLAYER
2 OR MORE PLAYERS
SELECT YOUR PRIVATE LESSON (2 or more)
*
1 Hour - 2+ Players ($65pp)
2 Hours - 2+ Player ($120pp)
3 Hours - 2+ Player ($180pp)
4 Hours - 2+ Player ($230pp)
5 Hours - 2+ Player ($280pp)
6 Hours - 2+ Player ($320pp)
7 Hours - 2+ Player ($360pp)
8 Hours - 2+ Player ($400pp)
9 Hours - 2+ Player ($440pp)
10 Hours - 2+ Player ($440pp)
SELECT YOUR PRIVATE LESSON (1 Player)
*
1 Hour - 1 Player ($90)
2 Hours - 1 Player ($180)
3 Hours - 1 Player ($270)
4 Hours - 1 Player ($345)
5 Hours - 1 Player ($420)
6 Hours - 1 Player ($495)
7 Hours - 1 Player ($570)
8 Hours - 1 Player ($620)
9 Hours - 1 Player ($670)
10 Hours - 1 Player ($670) 10th Lesson is FREE
If you have a coupon code enter it here.
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Emergency Contact name(s) Number(s)
*
In my completion and submission of this form I agree that I have accepted a place on a Scottish Soccer Academy 2019-20 roster. I understand that this place is non-refundable unless the program is cancelled by the Scottish Soccer Academy. My place is only secure when my registration has been fully completed and my participation fee has been paid in full.
*
I AGREE