2025 Camp Cup

2025 CAMP CUP

January 4-5th

Skate Safe America

182 Bethpage Sweet Hollow Road

Old Bethpage, NY 11804

Athlete Information

Player Name*

First NameLast Name

Mom's Name

First NameLast Name

Mom's Email

Dad's Name

First NameLast Name

Dad's E-mail

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone*

Area CodePhone Number

Home Phone

Area CodePhone Number

E-mail*

Division*

Camp (8th Grade and Under)*

Camp (11th Grade and Under)*

Camp (Alumni)*

Payment Method (Team Fee - $995 -- INDIVIDUAL FEE - $150)*

Team Fee - $995 -- INDIVIDUAL FEE - $150 (Visa, MasterCard and Discover Only!)*

USDTeam Fee

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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