Player Registration Form (Summer Camp)

Parent/Guardian Information

First Name *

Last Name *

Email Address *

Phone *

DOB *

Format: month/day/year

First Name *

Last Name *

DOB *

Format: month/day/year

Gender *

Add Siblings

How many Siblings? *OneTwoThree(max. 3 per application)

First Name *

Last Name

DOB *

Format: month/day/year

Gender *

First Name *

Last Name *

DOB *

Format: month/day/year

Gender *

First Name *

Last Name *

DOB *

Format: month/day/year

Gender *

Jun (06) - 10th to 13thJun (06) - 24th to 27thJul (07) - 8th to 11thJul (07) - 22nd to 25thYou can pick one week or multiple

Price per Player

$

Price per player/registration (Hidden)

SubTotal Payment

$

Total Payment

$

Consent *

I hereby that all information added is accurate.

Take Your Soccer To The Next Level!