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Note: Coaches will receive a discount code for $40 off of registration. Inquire with PeakSoccer@gmail.com to receive your code.

Additional Participants - Peak to Peak Soccer Registration Form

Participant Name

First Name

Last Name

Birth Date

YYYY

Upcoming Grade

Number of Years Played

Ordering a New Jersey?

All participants must have a Peak to Peak Soccer jersey. However, you can re-use jerseys from prior years if available.

Yes

Medical Conditions

Please be specific and describe how you would like the coach to handle it. Type "None" if so.

Comments / Scheduling Conflicts or Concerns

Type "None" if so.

Parent/Guardian Info

Parent/Guardian #1 Name

First Name

Last Name

Any changes from first registration?

Please use this field to describe any differences in parent/guardian or Emergency Contact information, between this participant and a previously registered participant. Type "None" if so.

Terms & Conditions

By submitting this application, you affirm that you have read and understood the Code of Conduct & Waiver (linked below) and that you agree to abide by these rules.

Discount Codes:

Note that you may use the discount code 2PAK or 3PAK at checkout to receive your bulk discount on registration.

We accept payment online via Credit Card and PayPal/Venmo. If you would like to pay with cash or check, you may drop it off or mail it to the Teen Center and we will help complete your registration at that time.