Summer Camp Application

First Name:

Last Name:

Date of Birth:

Age:

Parents Name(s):

Email Address:

Home Phone:

Cell Phone:

Address:

City:

State:

Zip:

Gender:

Position:

T-Shirt Size

Camp

Ages:

Prices:

Soccer City, Inc. is not responsible for articles lost or stolen. All players are required to have their own medical insurance. The facility will not be held liable for any injury sustained during the competition or instruction. I agree to follow the above regulations and all other rules governing the competition or instruction.

Signature: