2015 Memphis Women's Soccer ID Camp - Oasys Sports
2015 Memphis Women’s Soccer ID Camp Saturday, July 25th $125 Two Sessions: (8:00AM - 10:30AM) & (4:00PM - 6:30PM) Campus Tour (optional): 1:00pm – 3:00pm Location: Park Avenue Campus, 1115 E. Getwell Loop, Memphis, TN 38152
Camper Name: ________________________________________________________________
E-mail address: __________________________ Grad Year: __________________ Cell Phone: __________________ __ Home Phone: ________________________ Home address: ______________________________________________________ City: ____________________________ State: _____________ Zip: ____________ Club team: __________________________________ Position: ______________ Want to attend the campus tour: YES or NO Parent/Guardian Release In accordance with the rules of the Memphis Soccer ID Camp, I hereby give my consent for the aforementioned camper to participate in the soccer camp and all related camp activities. If at any time it is necessary for the aforementioned camper to receive outside or professional medical attention, I hereby give my consent to the camp to secure services of the physical or medical facility selected and to secure transportation as is deemed necessary. I will not hold he camp responsible or any benefits beyond the camp medical insurance program and will secure adequate family insurance coverage if additional protection is desired. Parent/Guardian Signature: ______________________________________ Date: ________________________ Emergency Contact: _____________________________________ Phone #: ____________________________ Make Checks Payable to Head Coach: Brooks Monaghan Mail in check and form to: (We will send you a confirmation e-mail when we receive your check) University of Memphis AOB Women’s Soccer Room 207 570 Normal Street, Memphis, TN 38152 E-mail assistant coach Lizzy Simonin for additional questions: [email protected]; 816-305-5506
Camper Name: ________________________________________________________________
E-mail address: __________________________ Grad Year: __________________ Cell Phone: __________________ __ Home Phone: ________________________ Home address: ______________________________________________________ City: ____________________________ State: _____________ Zip: ____________ Club team: __________________________________ Position: ______________ Want to attend the campus tour: YES or NO Parent/Guardian Release In accordance with the rules of the Memphis Soccer ID Camp, I hereby give my consent for the aforementioned camper to participate in the soccer camp and all related camp activities. If at any time it is necessary for the aforementioned camper to receive outside or professional medical attention, I hereby give my consent to the camp to secure services of the physical or medical facility selected and to secure transportation as is deemed necessary. I will not hold he camp responsible or any benefits beyond the camp medical insurance program and will secure adequate family insurance coverage if additional protection is desired. Parent/Guardian Signature: ______________________________________ Date: ________________________ Emergency Contact: _____________________________________ Phone #: ____________________________ Make Checks Payable to Head Coach: Brooks Monaghan Mail in check and form to: (We will send you a confirmation e-mail when we receive your check) University of Memphis AOB Women’s Soccer Room 207 570 Normal Street, Memphis, TN 38152 E-mail assistant coach Lizzy Simonin for additional questions: [email protected]; 816-305-5506
