No Value Purchase
| REGISTRATION INFORMATION | |
| First Name: | Dan |
| Last Name: | Test |
| Email Address: | test@test.com |
| Street Address: | 1 Test St. |
| Address Line 2: | |
| City: | Boston |
| State: | MA |
| Zip Code: | 02134 |
| Phone: | |
| MEMBERSHIP PACKAGE | |
| Membership Options: |
Unity Membership: $40 |
| Additional Unity Membership: ($40) | |
| Additional Basic Membership: ($20) | 2 |
| T-Shirt Size Selection: sml: med: lrg: xl: xxl: 2 xxxl: |
|
Enter your order total below and click the Google Checkout button to complete purchase.
Alternatively, you can mail a check or money order to: Street Soccer NYC, 5 Hanover Square, NY, NY 10004
Please print this page and include it with your check. Your order will processed when your check is received.
*Does your company match charitable donations? If so, please consider initiating a matching gift from your employer.
Paid for by Street Soccer USA
+ Power and Design from Boston + Liberty Concepts +