LMSC Spring Training Programs

This is the registration form for the Lower Merion Soccer Club's Spring Training Programs. There are two options for payment:
OPTION ONE: Send in a check for $130, payable to "LMSC." Please mail it to LMSC, Box 360, Bryn Mawr, PA 19010.
OPTION TWO: Pay by credit card. There is a transaction fee for using a credit card. Your credit card will be charged $134.07
Child's Last Name*
Child's First Name*
Training Program Choice*
- 2013-2014 Birth Training Program
- Travel Team Training Program
Address*
Street Address Address Line 2 City State ZIP Code
Parents' Names
E-Mail Address*
Enter Email Confirm Email
Second E-Mail Address (Optional)
Enter Email Confirm Email
Phone*
Gender*
- Male
- Female
- Other
Birthdate*
Date Format: MM slash DD slash YYYY
Most Recent Soccer Program*
Please write in the most recent soccer program that the player participated in.
Payment Choice:*
Training Program Fee: $130*
Price: $130.00
Bank Fee
Price: $0.00
Total Amount To Be Applied To Credit Card
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Additional Comments
Please feel free to enter any additional comments here: