Drills & Scrimmages at Takoma Park Middle School field & gym
Director - Adrian Baez, Einstein varsity coach
Have Fun! Learn Soccer!
Half-day program (9 a.m. - Noon)
Monday - April 10th - thru - Friday - April 14th
You will be sent an email with a full list of information.
For questions contact Howard Kohn (email@example.com).
Names of Parents
Phone (home) (work)
E-mail address (important!)
Name & Number of Emergency Contact (during program week):
Medical Needs or Other Special Information:
I hereby give my child permission to participate in this soccer program.
I understand that no accident insurance is provided,
and I agree that I will not hold Takoma Soccer or
the Takoma Park Recreation Department responsible for
any injury sustained while participating in this program.
Signature of Parent or Guardian ______________________________________________
Fee: $75 (Write checks to Takoma Soccer)
Mail to: Takoma Soccer, 16 Jefferson Ave, Takoma Park, MD 20912