Iglesia Bautista Roca Eterna

3rd Torneo de Futbol

 

Lugar:  Chinn Aquatics & Fitness Center

              13025 Chinn Park Drive

              Prince Williams, VA  22192

http://www.pwcparks.org/Recreation/ChinnAquaticsFitnessCenter/FindUs/tabid/87/Default.aspx

 

Fecha:  Todos los Domingos, comenzando Junio 22, 08

Hora:   4:00 PM y- 6:00 PM

Costo:  $85.00 por jugador

Info:     Pastor Manuel Chacón (703)819- 6336

               Nery Cruz (703) 247-9464

 

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Registración: (por favor llene una forma por cada jugador/a)

 

Nombre:

 

Nombre de los Padres (si es menor de 18 años):                                                                                  

 

                                                                                                                                                           

 

Dirección:

 

Teléfono: Casa                                   Trabajo                          Celular

 


Cumpleaños                                                 

 

Información médica (Incluya alergias a algun alimento):

 

 


Contacto de emergencia:

 

Nombre:                                                                               Teléfono

                                                           

Teléfono:

 


¿Asiste usted a alguna Iglesia? ¿Cuál?

 

 

 

 

 

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Iglesia Bautista Roca Eterna

3rd Soccer Tournament

 

Lugar:    Chinn Aquatics & Fitness Center

              13025 Chinn Park Drive

              Prince Williams, VA  22192

http://www.pwcparks.org/Recreation/ChinnAquaticsFitnessCenter/FindUs/tabid/87/Default.aspx

 

Date:    Every Sunday, Starting June 22, 08

Time:   4:00 PM and 6:00 PM

Cost:    $85.00 per player

Info:     Pastor Manuel Chacón (703)819- 6336

               Nery Cruz (703) 247-9464

 

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Registration: (please fill out 1 form per player)

 

Name:

 

Name of parents (minor of 18):                         __________                                                               

 

                                                                                                                                                           

 

Address:

 

Phone: House                                        Work                                       Cell

 


Birthdate                                                      

 

Medical information (please include if you are alergic to any food):

 

 


Emergency contact:

 

Name:                                                                      relation:                                                               

                                                           

Phone:                                                   Cell:                                                                           

 

¿Do you attend a church? Yes __   No ­­­__ ¿Name of the church?