#areuin? Program

#areuin? Program

Once your #areuin? Program number is verified, you will receive 75% discount on program registration fees. You will be responsible for 25%. If you have any questions about this program, please email krichard@utdsportsfoundation.org
Type of Contact *
Gender *
What program you are registering for? *

Monday 4-5 Yr Old Grassroots 3-3:45 pm in Hampton Monday 6-8 Yr Old PlaySoccer 4-5 pm in Hampton Tuesday 4-5 Yr Old Grassroots 4-4:45 pm in Epping Wednesday 3-4 Yr Old Grassroots(parent participation) 10:30-11:15 am in Hampton Friday 7-8 Yr Old Skills & Scrimmage 4-5 pm in Epping Satruday 3-4 Yr Old Grassroots(parent participation) 9:30-10:15 am in Hampton Saturday 4-5 Yr Old Grassroots 11:30-12:15 pm in Hampton
Participant First Name *
Participant Last Name *
Participant Date of Birth *

Month Day Year

Participant Address *

Parent/Guardian Address

Phone Number *

Area Code Phone Number
Mobile

Area Code Phone Number
Email *
example@example.com
#AreUIn Card Number *
This number will be verified before you receive your discount
Should be Empty: