Sports Registration Form

2026 BKYSC REGISTRATION
This 3-day camp is for boys and girls entering grades 1-6. BKYSC features Hempfield coaches and current high school boys/girls soccer players who will lead players through drills and games to improve skills, develop confidence, and promote the enjoyment of the game!

Who: Boys and Girls entering grades 1-6 (2026/27 school year)
When: 6/22 to 6/24 (6:00-7:30pm)
Where: Hempfield High School Quad Turf Fields - 340 Mumma Dr, Landisville, PA 17538
Player Name*

First NameLast Name
Grade Entering 2026/27 School Year*

1st2nd3rd4th5th6th
Parent Contact Name*

First NameLast Name
Parent Contact Phone*
Format: (000) 000-0000.
Parent Contact E-mail*
example@example.com
Have you attended our camp before?*

YesNo
Medical/Allergy Info - if applicable (Please list any information the staff should be made aware of about your child)
Questions about camp?
Early Registration (Before May 15th) - $50
Regular Registration (After May 15th) - $60
Payment accepted via credit card or venmo below
Refunds cannot be issued after May 31st

Questions: Contact jrm50008@gmail.com

Thank You,

Mark Ashley - Head Boys Soccer Coach
Jason Mackey - Head Girls Soccer Coach
Waiver of Libiability

In consideration of my child being allowed to participate, I hereby release, waive, discharge, and covenant not to sue the Black Knight Youth Soccer Camp, its directors, officers, employees, coaches, volunteers, sponsors, and affiliated organizations (collectively, the “Released Parties”) from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by my child, whether caused by the negligence of the Released Parties or otherwise, to the fullest extent permitted by Pennsylvania law. I certify that my child is physically fit and has no medical condition that would prevent safe participation. I agree to inform Camp staff of any relevant medical conditions or allergies. I consent to emergency medical treatment for my child if necessary and understand that I am responsible for any resulting medical expenses. I acknowledge that the Camp may use photographs or videos of my child for promotional purposes without compensation. I have carefully read this waiver and fully understand its terms. I understand that I am giving up substantial rights, including the right to sue.
Signature*
Payment*
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Early Registration
$50 Early discount + processing fee

$51.00

Total

$0.00
Payment Methods

Choose from one of the PayPal options to make your payment.
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2026 BKYSC REGISTRATION

Waiver of Libiability