REGISTRATION

Pura Vida GK Academy Lakeland/Plant City September Registration

September Wednesdays: 2nd, 9th, 16th, 23rd

Session details

Wednesdays: 2nd, 9th, 16th, 23rd Beginners (never trained, starting in position, playing recreational leagues) @ 4:30 PM Advanced group (Competitive/Travel Leagues ECNL, MLS, etc. GK training experience) @ 5:30 PM Ellis Methvin Park — 120 N Wilder Rd, Plant City, FL 33563 GK Coach: Daniel Melo Inquiries: contact Coach Jonathan at 813-580-1310

Location: Ellis Methvin Park

120 N Wilder Rd, Plant City, FL 33563

Coach: Daniel Melo

Athlete information

First name

Last name

Birth date

Gender

Club / school (optional)

League (optional)

Parent / guardian contact

First name

Last name

Phone

Street address

Apt / suite (optional)

City

State

ZIP

Choose your package

Attendance dates

Optional — if you already know which sessions you will attend, list them here. Otherwise you can let us know later.

Dates you plan to attend

Waivers & confirmation

I have read and agree to the liability waiver / release of liability.

I have read and agree to the medical and photo release.

I confirm that the information above is accurate and I am authorized to register this athlete.

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