JBU Men's Soccer Team Camp Registration
Please complete all sections below to secure your spot.
Registrant & Player Information
Registrant Type
*
Player
Parent/Guardian
First Name
*
Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Street Address
*
City
*
State / ZIP
*
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School & Team Info
High School Name
*
Graduation Year
*
Please Select
2025
2026
2027
2028
2029
2030
Head Coach Name
*
First Name
Last Name
Head Coach Email
*
example@example.com
Head Coach Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Team Name
*
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Soccer Information
Primary Position
*
Please Select
Goalkeeper
Defender
Midfielder
Forward
Secondary Position
Please Select
Goalkeeper
Defender
Midfielder
Forward
Jersey Number
*
Years of Experience
*
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Parent/Guardian Information
Parent/Guardian Full Name
*
First Name
Middle Name
Last Name
Relationship to Player
*
Please Select
Mother
Father
Guardian
Other
Parent Email
*
example@example.com
Parent Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Emergency Contact
Emergency Contact Name
*
First Name
Middle Name
Last Name
Relationship to Camper
*
Please Select
Parent
Guardian
Sibling
Grandparent
Relative
Family Friend
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical Conditions or Allergies
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Waiver & Liability
Liability Waiver
Signature
*
My Products
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JBU Men's Team Camp
$75.00
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Date
*
-
Month
-
Day
Year
Date
Submit
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