Maverick Soccer Camp 2025 Registration Form

2025 Maverick Soccer Camp Registration

July 23, 24, and 25, 2025

Athlete Information

I want to register THIS many players:*

Siblings from the same household after the 1st player are 50% off (siblings & step-siblings only please). If you have more than 4 children, please email us at mavsoccercamp@gmail.com

Player Name*

First NameLast Name

Gender*

Shirt Size*

Grade Entering in the Fall*

Player 1. Does the athlete have any allergies, chronic illness, or medical conditions?*

YESNO

Player 1. Please describe allergies, illnesses, medical conditions.*

Player 1

Player 1. Is the athlete prescribed an inhaler?*

Player 1. Please make CERTAIN they have it with them, and explain treatment/dosing instructions below.*

Player 1

I would like to register a sibling from the same household. Siblings/step/"half" siblings only please. 1st player full price, each sibling afterwards is 50% off)

Yes

Sibling 1 Name

First NameLast Name

S1 Gender

S1 Shirt Size

S1 Grade Entering in the Fall

Sibling 1. Does the athlete have any allergies, chronic illness, or medical conditions?

YESNO

Sibling 1. Please describe allergies, illnesses, medical conditions.

Sibling 1

Sibling 1. Is the athlete prescribed an inhaler?

Sibling 1. Please make CERTAIN they have it with them, and explain treatment/dosing instructions below.

Sibling 1

I would like to register a 2nd sibling from the same household. Siblings/step/"half" siblings only please. 1st player full price, each sibling afterwards is 50% off)

YesNo

Sibling 2 Name

First NameLast Name

S2 Gender

S2 Shirt Size

S2 Grade Entering in the Fall

Sibling 2. Does the athlete have any allergies, chronic illness, or medical conditions?

YESNO

Sibling 2. Please describe allergies, illnesses, medical conditions.

Sibling 2

Sibling 2. Is the athlete prescribed an inhaler?

Sibling 2. Please make CERTAIN they have it with them, and explain treatment/dosing instructions below.

Sibling 2

I would like to register a 3rd sibling from the same household. Siblings/step/"half" siblings only please. 1st player full price, each sibling afterwards is 50% off)

YesNo

Sibling 3 Name

First NameLast Name

s3 Gender

S3 Shirt Size

S3 Grade Entering in the Fall

Sibling 3. Does the athlete have any allergies, chronic illness, or medical conditions?

YESNO

Sibling 3. Please describe allergies, illnesses, medical conditions.

Sibling 3

Sibling 3. Is the athlete prescribed an inhaler?

Sibling 3. Please make CERTAIN they have it with them, and explain treatment/dosing instructions below.

Sibling 3

Parent Name*

First NameLast Name

Parent Email*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number #1 (Parent 1 Cell, etc)*

Area CodePhone Number

Phone Number #2 (Parent 2 Cell, etc)

Area CodePhone Number

Emergency Contact's Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Relationship to player(s)*

Informed Consent, Acknowledgement and Medical Release & Authorization

I hereby give my approval for my child/children’s participation in any and all activities during the ACHS Soccer Camp. There is a risk of being injured that is inherent in all sports activities, including soccer. Playing soccer with others also carries the risk of contracting the COVID-19 virus and other illnesses. I assume all risk and hazards incidental to the conduct of the activities, and in case of any injury to, or any illness contracted by, said child/children, I hereby waive all claims against, release, absolve and hold harmless Chris Curtin, Anderson County High School, Anderson County Schools, Lady Maverick Soccer Boosters, all camp coaches, staff, faculty, volunteers, all other players and parents, Maverick Soccer Camp and all its respective officers, agents, and representatives from any and all liability for injuries to, or illness contracted by, said child/children arising out of participation in any and all camp sessions and activities, accidental or otherwise. I/We further grant permission to Camp staff/coaches and ACHS, any physicians, athletic trainers, and/or EMTs or other personel to render aid, treatment, medical, or surgical care deemed reasonably necessary to the health and well-being of the child/children named above during or resulting from participation in Maverick Soccer Camp.

I HEREBY ACKNOWLEDGE AND AGREE TO ALL ITEMS ABOVE. BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS LEGALLY BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Use your mouse/touchscreen to sign at the line please.*

Admin Use Only

Player Information

Parent/Guardian Information

Emergency Contact Information

Complete Registration & Payment