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Midland Soccer Coaching - Great Coaching, Great Football, Great Fun

General Course & Fun Weeks Registration & Payment

PAYMENT MUST BE MADE AT THE TIME OF REGISTRATION

Please use the form below to register for a fun weeks course or general course and make payment via PayPal.

All fields highlighted in green are mandatory.

Course:
Web:
Parent/Guardian Name:
Email:
Emergency Telephone:
Mobile Phone:
Course Name:
Course Date:
Location:
Enquiry:
Where did you hear about us?:
CLICK TO ADD ANOTHER CHILD
Name: Age: Date Of Birth:
Email Signup:	Please tick this box if you would like to OPT IN for email news & offers. Your details will not be passed to any third parties unless you request us to do so.

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Have you got any questions?

We are happy to answer any of your questions, simply use the contact us tab above.

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General Course & Fun Weeks Registration & Payment

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Midland Soccer Coaching