NEW ALBANY YOUTH SOCCER CAMP
NEW ALBANY YOUTH SOCCER CAMP
When:
JUNE 12TH-16TH
June 12th-16th 4:45-7:00 PM Grades K-4th 7:00-9:15 PM Grades 5th-8th Boys and Girls Grades K-8
Who: Where: Eagles Stadium, New Albany HS Cost: $75 Early Enrollment, $85 after June 1st Includes Camp T-Shirt
Campers of the Day Daily Raffle Items High School Soccer Players Camp Director: Johnny Ulry
[email protected]
New Albany Eagles Summer Soccer Camp YOUTH INDIVIDIAL PLAYER CAMP - Registration Form For Boys and Girls going into Grades K– 8th Camper First Name:
________________________________Camper Last Name:
______________________________________
Parent Email: _________________________________________________________________ Address ______________________________________________________________________________________________ City _______________________________________________________ State _______________ Zip___________________ School _______________________________________ Grade entering next year _______________ T-Shirt Size: Camper Gender: Male Female
Camper’s Primary Position:
YS
YM
YL
AS
AM
AL
AXL
Goalkeeper
CONSENT FOR MEDICAL TREATMENT (MINOR) By agreeing to the terms and conditions, I release my child to participate in the New Albany Eagles Summer Soccer Camp (NAESSC). I recognize that my signature on this release is a condition of your permitting my child to participate. I certify that my child is in excellent physical health, and may participate in physical activities at camp. I certify that there are no physical limits to my child's participation in the camp. Permission is granted for my child to receive emergency medical treatment if needed. I hereby release and discharge NAESSC, and all their affiliated entities from any and all liability, claims, demands, and causes of action for personal injury, property damage, and/or other loss suffered by my child in connection with his/her participation in the camp. I represent that I am a parent/guardian of the minor named above and I agree that the grant and release contained therein binds me and the minor to all its terms. I do hereby authorize NAESSC and its assigns to utilize any and all photographs, pictures or other likeness of my child or any participant assigned guardianship to me, as they deem appropriate in its promotional materials.
Parent First Name:
________________________________Parent Last Name:
______________________________________
Signature of Parent/Guardian X_________________________________________________________ Date_____________ Parent Contact Number:
Mobile:
__________________________________ Home: ___________________________________
Any Medical Info you want us to know about: _____________________________________________________________________
______________________________________________________________________________
EĞǁůďĂŶLJ Eagles Soccer Camp (please select)
Regular Price
Early Registration (By June 1)
____ :ƵŶĞ 12-16, 2016 – 4͗45Ͳϳ͗ϬϬ PM
$ 85.00
$75.00
____ JƵŶĞ12Ͳ16, 2016 – ϳ͗ϬϬͲϵ:15 PM
$ 85.00
$75.00
**** For Camp with Early Discount Available –Registrations qualify if form is completed and paid in full by June 1.
____ (SIBLING DISCOUNT, $15 DISCOUNT )
-$15
Total Cost of Camp
Please enclose the full amount due and mail to: New Albany Eagles Summer Soccer Camp, 7600 Fodor Rd, New Albany, Ohio, 43054 Make checks payable to: New Albany Athletics Attn: Johnny Ulry
-$____________
__________________
When:
JUNE 12TH-16TH
June 12th-16th 4:45-7:00 PM Grades K-4th 7:00-9:15 PM Grades 5th-8th Boys and Girls Grades K-8
Who: Where: Eagles Stadium, New Albany HS Cost: $75 Early Enrollment, $85 after June 1st Includes Camp T-Shirt
Campers of the Day Daily Raffle Items High School Soccer Players Camp Director: Johnny Ulry
[email protected]
New Albany Eagles Summer Soccer Camp YOUTH INDIVIDIAL PLAYER CAMP - Registration Form For Boys and Girls going into Grades K– 8th Camper First Name:
________________________________Camper Last Name:
______________________________________
Parent Email: _________________________________________________________________ Address ______________________________________________________________________________________________ City _______________________________________________________ State _______________ Zip___________________ School _______________________________________ Grade entering next year _______________ T-Shirt Size: Camper Gender: Male Female
Camper’s Primary Position:
YS
YM
YL
AS
AM
AL
AXL
Goalkeeper
CONSENT FOR MEDICAL TREATMENT (MINOR) By agreeing to the terms and conditions, I release my child to participate in the New Albany Eagles Summer Soccer Camp (NAESSC). I recognize that my signature on this release is a condition of your permitting my child to participate. I certify that my child is in excellent physical health, and may participate in physical activities at camp. I certify that there are no physical limits to my child's participation in the camp. Permission is granted for my child to receive emergency medical treatment if needed. I hereby release and discharge NAESSC, and all their affiliated entities from any and all liability, claims, demands, and causes of action for personal injury, property damage, and/or other loss suffered by my child in connection with his/her participation in the camp. I represent that I am a parent/guardian of the minor named above and I agree that the grant and release contained therein binds me and the minor to all its terms. I do hereby authorize NAESSC and its assigns to utilize any and all photographs, pictures or other likeness of my child or any participant assigned guardianship to me, as they deem appropriate in its promotional materials.
Parent First Name:
________________________________Parent Last Name:
______________________________________
Signature of Parent/Guardian X_________________________________________________________ Date_____________ Parent Contact Number:
Mobile:
__________________________________ Home: ___________________________________
Any Medical Info you want us to know about: _____________________________________________________________________
______________________________________________________________________________
EĞǁůďĂŶLJ Eagles Soccer Camp (please select)
Regular Price
Early Registration (By June 1)
____ :ƵŶĞ 12-16, 2016 – 4͗45Ͳϳ͗ϬϬ PM
$ 85.00
$75.00
____ JƵŶĞ12Ͳ16, 2016 – ϳ͗ϬϬͲϵ:15 PM
$ 85.00
$75.00
**** For Camp with Early Discount Available –Registrations qualify if form is completed and paid in full by June 1.
____ (SIBLING DISCOUNT, $15 DISCOUNT )
-$15
Total Cost of Camp
Please enclose the full amount due and mail to: New Albany Eagles Summer Soccer Camp, 7600 Fodor Rd, New Albany, Ohio, 43054 Make checks payable to: New Albany Athletics Attn: Johnny Ulry
-$____________
__________________
