Greenbrier Soccer Club, Greenbrier Arkansas Registration fees for Level I, boys and girls 4-7 yrs. is $60
Level II for boys and girls 8 yrs+ is $75.
Fee includes uniform for levels I &II.
Classic/ Level III teams are $90, not including uniform.
$5 off per family for multiple registrations.

Mail To: Details on the next page.
Use the button at the bottom of this page.

Or Click Here and Download the PDF version.

.

Complete this form and click the Print My Form button at the bottom.
Last Name
 First Name
Address
 City
 State
 Zip
Telephone
 Cell Phone
 Email
Birthdate
 Age
 Sex
Male      Female
What Coach Did Child Have In The Fall? (Teams from fall will stay together if possible)
Father's Name
 Cell Phone
 Work Phone
 Email
Mother's Name
 Cell Phone
 Work Phone
 Email
Mother's Birthdate (For Player ID numbers only)
 Interested in Coaching
Yes      No
Interested in Volunteering;
Referee   Fundraising   Field Work   Concessions   Board Member
In An Emergency when parents cannot be reached, please contact;
Name
 Phone
 Work Phone
 Cell Phone
Allergies or other medical conditions;
Player's Physician
 Phone
 Insurance Co.
Insurance Phone
 Policy #
 Group #
 Policy Holder
Number of Seasons Played
 Uniform Size
(Birth certifi cate will be required for tournament play only.)