Three Lions Summer Camp Registration 2017

Please print out this application page for each child attending:

Players Information

Name …………………………………………………………………………………………………………………………………………………..

Gender ………………………………………………………………………………………………………………………………………………..

Age …………………………………………………………………………………………………………………………………………………….

 

Parent/Guardian Information

Parents Name ……………………………………………………………………………………………………………………………………..

Parents Phone Cell …………………………………………… Home ……………………………………………………………………..

Parents Email ……………………………………………………………………………………………………………………………………..

 

Emergency Information (in case of Emergency please provide alternative numbers)

Contact Name …………………………………………………………………………………………………………………………………….

Contact Phone ……………………………………………………………………………………………………………………………………

 

Please circle with the camp you wish to attend:

CAMP                                      Date                                       Times                                     Cost

 

Indoor Camper (10+)       May 30th-June 2nd, 2017    9:00 AM-12:00 PM    Tuition $89

                                                                     

Futsal Camper (14+)       May 30th-June 2nd, 2017   6:00 PM - 7:30 PM      Tuition $79 

 

Little Camper (3,4,5)        June 20th-23rd, 2017        8:00 AM-8:45 AM        Tuition $39

                                

Premier Camper (6-9)     June 19th-23rd, 2017       9:00 AM-12:00 PM       Tuition $89 (1/2 day)

                                   

                                           June 19th-23rd, 2017       9:00 AM-3:00 PM         Tuition $169 (full day)

 

                                

Elite Camper (10+)          June 19th-23rd, 2017       9:00 AM-12:00 PM       Tuition $89   (1/2 day)

                    

                                          June 19th-23rd, 2017       9:00 AM-12:00 PM       Tuition $169 (Full day)

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Payment

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Application is not valid until payment is received. Payment will not be prorated or refunded for non-attendance

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Please make checks payable to: James Phillips  

and Mail it to

 

James Phillips

2030 Blue Ridge Ave

Melbourne, FL 32935

 

Release

I hereby authorize the directors of 3 Lions Soccer Academy to act for me according to their best judgment in any event that my child may require medical attention. I also herby release and discharge Holy Trinity and 3 Lions Academy and its employees from any and all action regarding any known or unknown injuries that may occur while participating in the boy’s soccer camp. I know of no mental or physical problem that affects my child’s ability to safely participate in this camp. 

 

Parent/Guardian …………………………………………………………………………….. Date …………………………………………….