Youth Soccer Camp Registration Form

2025 Youth Soccer Camp

Presented by AHS Boys Soccer
Soccer Camp will take place on the following dates:

June 24,25,26

CHECK IN 5:45 PM

PICK UP 7:30 PM
Ages 6 to 12 : $35

*Group Rates : Email cspolyar@acsc.net with 3 or more player names that will attend, and we will send you a code to get $10 off. If you have 4 or more players, you will receive a code to get $15 off.

*You must email us first before payment so that the discount code may be applied.
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Additional Player Information
Name of School
Do you play for a Club?
If Yes, which club?
What position(s) do you play?
Preferred foot?
T-Shirt size
Parent/Guardian Information
Name*

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Address (if different from the player's)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by the AHS Boys Soccer Program during the selected camp. In exchange for the acceptance of said child’s candidacy by the AHS Boys Soccer Program and staff, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Anderson Community Schools, AHS Boys Soccer Program and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Anderson Community Schools, AHS Boys Soccer, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including soccer. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

I also consent to allow my player to be photographed for social media and camp/program promotion. I understand I nor my playerwill not be compensated.
I Agree

My Products

SESSION | AGES 6-9$35.00

SESSION | AGES 10-12$35.00

Enter coupon

Total $0.00

Credit Card

Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

2025 Youth Soccer Camp

Additional Player Information

Credit Card