* Required

Preferred number for contact​
Additional contact number​

Notes:

To register for Soccer Shots (Age 3-Gr.3), use this link instead: 
https://southeastpa.soccershots.com/search?txt=anci 

 
If class capacity is met, your registration will be placed on the waitlist.
 
This registration fee will be added to your FACTS account and taken out with your next scheduled debit.