Bayou City Lobos 2024 Summer Camp

Bayou City Lobos Summer Camp

Battle Line Sports Texas LLC- 2010 Pech Rd, Houston, TX 77055

Club Email: bayoucityfclobos@gmail.com

Mira Mupier - Technical Director

Telephone: 979-331-4010

Priscilla Blossom - Administrator

Telephone: 281-686-8430

Camp Dates

Monday, July 22nd - Friday, July 26th

Monday, July 29th - Friday, August 2nd

Monday, August 5th - Friday, August 9th

9:00am to 1:30pm

Cost:$310

(Lunch Provided)

Invoice will be sent after registration has been submitted.

Athlete Information

Player Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Player Date of Birth*

Date

Parent Information*

First NameLast Name

Cell Phone*

Area CodePhone Number

E-mail*

Soccer skill level*

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Week 1: July 22nd - July 26th - FULL, no longer accepting new registrationsWeek 2: July 29th - August 2nd - FULL, no longer accepting new registrationsWeek 3: August 5th - August 9th

Please list other players you want to be grouped with. This will be accommodated as best as possible.

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

YesNo

Please describe*

Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to the nearest hospital. I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility

Phone Number

Area CodePhone Number

Release of Liability Although the safety of all sport activities is the primary concern, soccer activities at Bayou City FC's rented facilities may cause injuries. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Bayou City FC Lobos, Battle Line Sports TX LLC and the persons in charge.

YesNo

Confirmation E-mail*

Signature*

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at bayoucityfclobos@gmail.com