Soccer Camp
Simon Kenton Soccer Camp Sponsored by SK Kickers and the SK Soccer Program Date: June 18th through June 21th Time: 6:00pm- 8:30pm Who: Ages 3rd grade to 8th grade in Fall of 2012 Place: Simon Kenton game field (on the turf field) Cost: $70.00 per person Family discounted cost: $110.00 2 players/$140.00 3 players Team discounted cost - $55.00 each (4 or more players from same team) Shirt and water bottle included in cost. Bring shin guards, ball and cleats
Participants Name:__________________ Age:______ Grade (fall of ’12)_______ Shirt size:________ Contact Information Contact person:____________________________ Phone #__________________ Contact e-mail address:_______________________________________________ Send form and check or money order to: Jeremy Wolfe 2130 Golden Valley Drive Independence, KY 41051 Make Checks payable to: Simon Kenton Soccer Questions contact: Jeremy Wolfe 359-0496 or [email protected] Applications accepted until 6:00pm on June 18th. In consideration of my child’s participation in this event, on behalf of myself, my child, and or heirs, assigns, executors, and personal representatives, I release, hold harmless, and discharge forever Simon Kenton High School their respective officers, directors, employees, agents and chaperones from any and all liability, claims, losses, damages, costs or expenses and waive and such claims against any such person or organization arising directly or indirectly from our attributable in any legal way to any action, omission or any act of such person or organization in connection with my child’s participation in this event. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by my child. I agree on behalf of myself, my child, and our heirs, assigns, executors, and personal representatives, to hold harmless and defend Simon Kenton High School, their respective officers, directors, employees, agents, and chaperones from any claim and/or damages to any person or property, arising from or in connection with my child’s participation in this event or in connection with any illness or injury (including death) or the cost of medical treatment of my child, and I agree to compensate Simon Kenton High School their respective officers, directors, employees, agents, and chaperones for reasonable attorney’s fees and expenses arising in connection therewith.
Parent/Guardian___________________________________Date____________
Participants Name:__________________ Age:______ Grade (fall of ’12)_______ Shirt size:________ Contact Information Contact person:____________________________ Phone #__________________ Contact e-mail address:_______________________________________________ Send form and check or money order to: Jeremy Wolfe 2130 Golden Valley Drive Independence, KY 41051 Make Checks payable to: Simon Kenton Soccer Questions contact: Jeremy Wolfe 359-0496 or [email protected] Applications accepted until 6:00pm on June 18th. In consideration of my child’s participation in this event, on behalf of myself, my child, and or heirs, assigns, executors, and personal representatives, I release, hold harmless, and discharge forever Simon Kenton High School their respective officers, directors, employees, agents and chaperones from any and all liability, claims, losses, damages, costs or expenses and waive and such claims against any such person or organization arising directly or indirectly from our attributable in any legal way to any action, omission or any act of such person or organization in connection with my child’s participation in this event. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by my child. I agree on behalf of myself, my child, and our heirs, assigns, executors, and personal representatives, to hold harmless and defend Simon Kenton High School, their respective officers, directors, employees, agents, and chaperones from any claim and/or damages to any person or property, arising from or in connection with my child’s participation in this event or in connection with any illness or injury (including death) or the cost of medical treatment of my child, and I agree to compensate Simon Kenton High School their respective officers, directors, employees, agents, and chaperones for reasonable attorney’s fees and expenses arising in connection therewith.
Parent/Guardian___________________________________Date____________
