Registration Form – Jefferson Boys Soccer

Booster Club Registration

Please complete and submit the following form, and Submit Payment. If registering more than one child in a household, only one Booster Club payment of $170.00 is required. Thank you!

Booster Club Registration

Player Information

Player Name

Player Email

Grade for 2024-2025 School Year

Player Name To Be Printed On Sweatshirt

Player Address

Address Line 1

Address Line 2

City

State

Zip Code

Player Phone Number

Parent/Guardian 1 Information

Parent/Guardian 1 Name

Parent/Guardian 1 Email

Parent/Guardian 1 Address (if different from player)

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian 1 Phone Number

Parent/Guardian 2 Information

Parent/Guardian 2 Name

Parent/Guardian 2 Email

Parent/Guardian 2 Address (if different from player & parent/guardian 1)

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian 2 Phone

Registration Fees

Which registration option is applicable?

Booster Club Registration Fee $170

Free/reduced lunch Booster Club Fee $0

Payment Options

Zelle – jagspayment@gmail.com
Square via website Booster Club Dues – Jefferson Soccer Boosters
QR Code below
Check to Treasurers Andrea or Brian

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