Sunday, January 27 Sunday, March 17th

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Name (Last) DOB

(First) /

/

(MI)_____

Age at Camp ___________ Grade _________________

Address ______________________________________________________________________ City

State

Zip _______

Parent/Guardian ________________________ Home Phone

Mobile Phone ___________________

Email address for confirmation _________________________________ School

Club team _____________________________

Please check desired camp session: $150 for each session

Sunday, January 27th

Sunday, March 17th

Please check desired position for camp training: Goalkeeper (a goalkeeper will not have the option to train as a field player at camp) Field Player: Position: Primary Foot:

Defender Right

Midfielder

Forward

Winger

Left

Applicants will be accepted on a first come, first serve basis. Enrollment will be limited and can only be secured by returning an application as soon as possible. The balance is due in full with registration. Upon receipt of application and payment, confirmation will be sent out via email. No credit card accepted: cash, check or money order please:

Please mail application and payment to:

UCF Soccer Camp 206 Vine St, Oviedo, FL 32765 Make checks payable to Bryan Cunningham’s Soccer Camp For more information please contact [email protected] 407-823-5827