Bungee Soccer Registration

Bungee Soccer 2018

BEGINS: Wednesday, June 27, 2018
TIME: 6:15 – 9:15 p.m.
LOCATION: Valley Bible Church, 1477 Willow Avenue, Hercules
COST: $40 (includes jersey) In order to register online, you must have a valid credit card.

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Bungee Soccer Registration

* Student Full Name

* Address

* City

* State

* Zip Code

* Student Phone

* Student Email

* Birthdate

* Grade entering in the fall

* Is this your first year at Bungee Soccer?

If yes, how did you hear about us?

* Have you played soccer before?

If yes, what league?

* Shirt Size

Parent/Guardian Info

* Parent/Guardian Email

* Parent/Guardian Mobile Phone

* Select 1

Emergency Contact

* First Name

* Last Name

* Phone Number

Payment Selection

* Registration Fee

Billing Address

* Country

* Address

* City

* State

* Zip Code

Payment Information

Total Price:

$0.00

* Credit Card Type

* Name on Credit Card

* Credit Card Number

* Expiration Date

* CCV Code

click here for help

CLICK THE SUBMIT BUTTON ONLY ONCE! Clicking twice may charge your card a second time.

Comments:

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CONTACT US

Manny deSouza
Director of Middle School Ministries
(510) 799-3171
mdesouza@valleybible.org

Leila Aragon
Admin. Asst. for VBC Youth
(510) 799-3171 ext. 121
laragon@valleybible.org

PAYMENT QUESTIONS?

Ron Hughes
Church Administrator
(510) 799-3171 ext. 158
rhughes@valleybible.org

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Sunday Services

9:00am & 11:00am

Location

1477 Willow Avenue
Hercules, CA 94547 • 510-799-3171

Get Directions

Bungee Soccer Registration

Bungee Soccer 2018

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