Summer Camp Detailed Registration Form

DATES/TIME

Monday - Thursday, June 22-25, 2026

Early Session	Late Session
5:00 - 6:30 PM	7:00 - 8:30 PM
Boys K-2nd	Girls K-2nd
Girls 3rd-8th	Boys 3rd-8th

How Many Children are you Registering

Camper 2

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Grade Entering this Fall
Shirt Size
Does the athlete have any allergies, chronic illness, or medical conditions that we need to be aware of? If yes, please describe.

Camper 3

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Grade Entering this Fall
Shirt Size
Does the athlete have any allergies, chronic illness, or medical conditions that we need to be aware of? If yes, please describe.

Camper 4

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Grade Entering this Fall
Shirt Size
Does the athlete have any allergies, chronic illness, or medical conditions that we need to be aware of? If yes, please describe.

Parent/Guardian Information
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Name #1

First NameLast Name
Cell Number #1
Format: (000) 000-0000.
Parent Name #2

First NameLast Name
Cell Number #2
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
To receive camp updates, weather alerts, and schedule changes, please join our Remind group before submitting this form

https://www.remind.com/join/jhscamp26

To join text @jhscamp26 to 81010
I have joined the Remind Text alert Group
Informed Consent and Acknowledgement

The participant has my permission to participate in the Jasper Wildcats Soccer Camp. I hereby waive and release the camp, coaches, counselors, and facilities of all liabilities arising from injuries incurred at the camp. I also accept all financial responsibilities and medical charges that may occur for medical treatment.

I give permission for my child to be photographed and for those photos to be used to promote future camps at Jasper High School.

If the participant has a pre-existing medical condition (i.e. asthma, diabetes, etc.) that the coaching staff should be aware of, please give further explanation on another sheet of paper, and include with registration.
Confirmation

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 BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Total Camp Cost

My Products

USDDescription

Credit Card

Date

MonthDayYear
Date
Signature

JHS Soccer Camp 2026
Should be Empty:

My Products*

Credit Card

JHS Soccer Camp 2026

My Products