Jackson Futbol Club 2019 Spring Break Camp March 11th – 15th Any players, male or female, aged 4-15 years old, whom enjoy soccer and are excited about learning how to become a better player are welcomed to attend. Campers will improve on their technical and tactical soccer ability while having a fun time. All staff members consist of highly skilled soccer coaches from Mississippi and/or national level coaches brought in specifically to help improve the quality of soccer in our area. Camp Director: Kevin Johns at 601-209-4567 or
[email protected] Camp Director: Perry Goldsbury at 601-212-2994 or
[email protected] Camp Times: Mon-Fri, 8:30AM – Noon. (Drop off can be as early as 7:30 AM)
Registration Fee: $125 + free Camp T-shirt. (Campers can sign-up the day of the camp).
Early Bird Discount: $15 per camper per camp (cut-off date is March 1st). Sibling Discount: $10 (First Child is full price then any additional child gets $10.00 Discount).
Camp Site: Jackson Futbol Club Complex, 2241 Westbrook Rd. Jackson, MS 39211 2019 JFC Spring Break Soccer Camp March 11th - 15th
Return bottom half of the form and check made payable to:
Registration Form
Perry Goldsbury 984 Woodbridge Dr, Madison, MS, 39110
Player Information
St First Name:
Last Name:
Age:
Address:
DOB:
City:
School & Grade:
Team & Coach:
State:
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Zip:
Coach Contact:
In Case of an Emergency Parent or Guardian: Cell:
Email address: Parent or Guardian work place & phone
T-Shirt Size: YS YM YL AS AM AL AXL (please circle) Please list any allergies or additional info on the back of this form. It is specifically understood and agreed that JFC Coaches shall not be responsible for any claim(s) or causes of action resulting from a participant’s injury while attending this soccer program. Parent’s understand and agree that each participant will not be permitted to attend and participate in the JFC Camp until this document has been signed and returned to the local coordinator, therefore, each participant will participate in the soccer program at his/her own risk. I have read and understand the terms of this agreement and, by signing, do release JFC Staff coaches from all liability resulting in the event of injury to my child.
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